瀛﹁€呰儭鏄ユ澗 鍙戣〃浜? 2010-5-22 21:12:46
鍒嗙被锛氱敓娲荤偣婊粹攤锛? 鈹? 娴忚锛?6       鎺ㄨ崘缁欐湅鍙?/span>  鍙傝禌鍗氭枃 (娴忚锛?6  璇勮锛? )

蹇冨绉戯細鏂拌蹇?鏂拌繘灞?

鍖椾含闃滃蹇冭绠＄梾鍖婚櫌  鑳＄洓瀵?span lang="EN-US">  鏁欐巿

鍗?鏄?澶?瀛?鍖?瀛?闄?span lang="EN-US">  鑳℃槬鏉?span lang="EN-US">  纭曞＋

锛堟敞锛氭湰鏂囦綔浜?span lang="EN-US">2008骞?span lang="EN-US">12鏈堬紝棣栨鍙戣〃銆傦級

鎻愯: 鏈枃闃愯堪浜嗗績澶栫鐨勬渶鏂拌蹇典笌鏈€鏂拌繘灞?span lang="EN-US">,鍐呭鍖呮嫭: 寮€鑳告墜鏈紝骞撮緞涓嶉檺锛涘厛蹇冩墜鏈紝鏅哄晢涓嶅噺锛涘啝鑴夋惌妗ワ紝鍦颁綅涓嶉檷锛涚摚鑶滃绉戯紝鍓嶆櫙涓嶈禆锛涘績鑴忕Щ妞嶏紝鎬у埆涓嶅悓锛涗汉宸ュ績鑴忥紝閬ヨ繙涓嶅啀锛涘井鍒涙墜鏈紝鎺ㄥ箍涓嶆槗锛涙潅浜ゆ墜鏈紝鍐呭涓嶅垎锛涘啀鐢熷尰瀛︼紝濂囪抗涓嶆柇锛涘績鑴忛夯閱夛紝杩涘睍涓嶅揩銆?/span>鐩镐俊瀹冨蹇冨绉戝熀纭€鐮旂┒涓庝复搴婂疄璺靛叿鏈夌幇瀹炴寚瀵兼剰涔夈€傚叏鏂囩害7400瀛椼€?/span>

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寮€鑳告墜鏈?span lang="EN-US">  骞撮緞涓嶉檺

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鍏堝績鎵嬫湳  鏅哄晢涓嶅噺

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鍐犺剦鎼ˉ  鍦颁綅涓嶉檷

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鏈€杩戠爺绌惰〃鏄庯紝寤惰繜鎷╂湡CABG鎵嬫湳鍙兘鏄湳鍚庢浜＄殑閲嶈鍗遍櫓鍥犵礌锛岃€屽強鏃舵帴鍙楁墜鏈€咃紝姝讳骸鍗遍櫓鍑忓皯1/3銆傚浜庡崐鍗遍噸鐥呬緥锛屽浗澶栨帹鑽?span lang="EN-US">CABG鎵嬫湳鏈€闀跨瓑寰呮椂闂翠负6鍛紙1.5涓湀锛夛紝闈炲嵄閲嶇梾渚嬫渶闀跨瓑寰?span lang="EN-US">12鍛紙3涓湀锛夈€傚績澶栫鍖荤敓鍩轰簬鎮ｈ€呯梾鎯咃紝鎵嬫湳棰勬湡鐩婂锛岀敤閫氬父鐨勬儻渚嬬‘瀹氭墜鏈揣鎬ョ▼搴︺€傚尰鐢熸帹鑽愮殑鍙婃椂鎵嬫湳鍙甫鏉ユ槑鏄剧殑瀛樻椿鐩婂銆傚綋鐒讹紝鑰冭檻鍒拌垂鐢ㄩ棶棰橈紝鍖荤枟鏈烘瀯寤虹珛鎮ｈ€呭畨鍏ㄧ瓑寰呮墜鏈殑鏃堕棿琛紝鏄闃蹭笉鑹悗鏋滅殑鏈夋晥鏂规硶銆傛槑纭強鏃舵墜鏈笌鏈悗姝讳骸鍗遍櫓涔嬮棿鐨勫叧绯绘槸閲嶈鐨勶紝渚夸簬鍖婚櫌閬垮厤鍥犱笉鑳芥帴鍙楃殑寤惰瀵艰嚧鎮ｈ€呭嵄闄╁鍔犮€傚洜姝わ紝CABG鍦ㄥ啝蹇冪梾娌荤枟涓殑鍦颁綅鏄笉瀹圭疆鐤戠殑銆?span lang="EN-US">

鐡ｈ啘澶栫  鍓嶆櫙涓嶈禆

涓诲姩鑴夌摚鎺у埗鐫€浠庡績鑴忎富娉佃厰锛堝乏瀹わ級鑷充富鍔ㄨ剦鍚戣韩浣撳叾瀹冮儴浣嶄緵琛€鐨勮娴併€備富鍔ㄨ剦鐙獎銆侀挋鍖栦娇鐡ｈ啘鐙獎鎹熷蹇冭剰娉佃鑳藉姏銆備富鍔ㄨ剦鐙獎鏄€佸勾浜烘渶甯歌鐨勫績鑴忕摚鑶滅梾涔嬩竴銆傚湪缇庡浗锛屾瘡骞存湁瓒呰繃5涓囦緥涓诲姩鑴夌嫮绐勯渶瑕佸绉戞墜鏈€備紶缁熺摚鑶滅疆鎹㈡墜鏈渶瑕佸紑鑳搞€佸績鑴忓仠璺崇害90鍒嗛挓锛屽湪涓诲姩鑴夌摚涓婂垏寮€鍔ㄨ剦锛屽垏闄ゅ師鍏堢殑鐡ｏ紝缂濅笂鏂扮摚鑶溿€傜劧鑰岋紝鐡ｈ啘缃崲鏈湁鐩婃垚鍗冧笂涓囧叾瀹冨仴搴风姸鍐佃壇濂界殑鑰佸勾鎮ｈ€呴鍚庣殑鍚屾椂锛屾浜＄巼涔熻秴杩?span lang="EN-US">10%銆?span lang="EN-US">

寰垱涓诲姩鑴夌摚鎼ˉ鏈娇涓嶅疁浼犵粺鐡ｈ啘缃崲鎵嬫湳鐨勯珮鍗辫€佸勾鎮ｈ€呰幏鐩娿€傝繖绉嶆柊鐨勪富鍔ㄨ剦鐡ｇ嫮绐勬惌妗ヨ€屼笉鏄疆鎹㈢殑澶栫鎵嬫湳锛屽彲鏈夋晥鍦版仮澶嶄粠蹇冭剰鍒拌韩浣撳叾瀹冮儴浣嶇殑琛€娴侊紝鎴愪负楂樺嵄鎮ｈ€呮湁鏁堢殑浼犵粺鐡ｈ啘澶栫鐨勪竴绉嶅畨鍏ㄦ浛浠ｆ墜鏈€?span lang="EN-US">

璇ユ柟娉曠О涓轰富鍔ㄨ剦鐡ｆ惌妗ユ湳锛屾槸涓诲姩鑴夌摚鐙獎鐨勯珮鍗辫€侀緞鎮ｈ€呯殑涓€绉嶉噸瑕佹不鐤楅€夋嫨銆傝鎵嬫湳鍙互鍦ㄥ績鑴忎笉鍋滆烦鐘舵€佷笅锛屽井鍒涙墜鏈畬鎴愩€備互鍓嶈涓鸿澶氭绫绘偅鑰呬紶缁熸墜鏈不鐤楁晥鏋滅敋寰€傜敱浜庤€佸勾浜轰富鍔ㄨ剦鐡ｇ疆鎹㈠彲鑳藉彂鐢熺殑鍗遍櫓锛岀害鏈?span lang="EN-US">60%鏈夌棁鐘朵富鍔ㄨ剦鐙獎鎮ｈ€咃紝涓嶆暍璐哥劧閫夋嫨澶栫鎵嬫湳娌荤枟銆傝繖浜涙偅鑰呯殑瀛樻椿鐜囪緝宸紝纭瘖鍚?span lang="EN-US">3骞村瓨娲荤巼浠呬负20%銆備絾缇庡浗蹇冭剰澶栫涓撳杩戜簲骞达紙2003-2007锛?span lang="EN-US">31渚嬨€佸钩鍧囧勾榫?span lang="EN-US">81宀併€侀珮鍗变富鍔ㄨ剦鐙獎鎮ｈ€呯殑鎼ˉ鎵嬫湳缁忛獙琛ㄦ槑锛屽浜庡嵄闄╀笂闄愮殑鍏稿瀷涓嶅疁鎵嬫湳鐨勮繖绫绘偅鑰咃紝鍙互浠庝富鍔ㄨ剦鐡ｆ惌妗ユ湳涓幏鐩娿€?

缇庡浗浠嬪叆鎬у績鑴忕梾涓撳鍙戞槑浜嗙敤涓€绉嶅井鍒涚粡瀵肩鐡ｈ啘缃崲鏈紝涓轰笉鑳借繘琛?ldquo;寮€蹇?rdquo;鎵嬫湳鐨勫績鑴忕梾鎮ｈ€呰繘琛屼簡蹇冭剰鐡ｈ啘缃崲銆備緥濡傚井鍒涜偤鍔ㄨ剦瀵肩涓村簥璇曢獙锛岀粡鐨績鑴忕摚鑶滅疆鎹㈢敤鐗涘績鍖呭績鑴忕摚鑶滐紝鍘嬬缉鑷宠繎浼间簬涓€鏀搮绗旂殑鐩村緞锛屼粠鑵块儴杩涘叆鍒板惊鐜郴缁熷苟绌胯繃鎮ｈ€呯殑鑲哄姩鑴夌摚鑶滆€屽睍寮€锛屾偅鑰呭悍澶嶈緝蹇€傚井鍒涚摚鑶滅疆鎹㈡湳鍦ㄥ績鑴忎笉鍋滆烦鐨勬儏鍐典笅锛屼笉鍊熷姪浣撳寰幆鎴栧紑鏀惧紡鑳搁儴鍒囧彛鎵嬫湳鑰岃繘琛岀摚鑶滅疆鎹紝涓旇緝涔嬩互寰€鎶€鏈彲澶уぇ缂╃煭鎮ｈ€呯殑鎭㈠鏃堕棿銆?/span>

寰峰浗绉戝瀹舵渶杩戝彂鏄庝簡涓€绉嶆柊鍨嬪績鑴忕摚鑶滅Щ妞嶆湳锛屽皢渚涗綋蹇冭剰鐡ｈ啘缁忚繃鐗规畩鐨?ldquo;绾寲”澶勭悊鍚庡啀妞嶅叆鍙椾綋锛屼笉浠呰兘閬垮厤鎺掑紓鍙嶅簲锛屼笖妞嶅叆鐨勭摚鑶?span lang="EN-US">-- 涓€涓被浼间簬绌烘鏋剁殑鐡ｈ啘缁撴瀯锛屽彲涓庡彈浣撳叡鍚岀敓闀垮彂鑲层€傛澶栵紝杩樺彲浠ヤ娇鎮ｈ€呭厤闄ょ箒鏉傜殑鍚庣画鎵嬫湳娌荤枟銆?/span>

蹇冭剰绉绘  鎬у埆涓嶅悓

蹇冭剰绉绘鏄皢娲讳綋蹇冭剰浠庝竴涓釜浣撳悜鍙︿竴涓綋绉绘锛屽彧瑕佽兘鏈夋晥鎺у埗鎺掓枼鍙嶅簲锛屾墜鏈悗鎮ｈ€呭氨鍙畨鍏ㄥ瓨娲汇€傜洰鍓嶅績鑴忕Щ妞嶆墜鏈湪鎶€鏈笂鏄瘮杈冩垚鐔熺殑锛屼富瑕佺殑闂鏄緵浣撳績鑴忎弗閲嶇煭缂?/span>銆?span lang="EN-US">

鑰?/span>缇庡浗鏈€鏂扮爺绌跺彂鐜帮紝蹇冭剰绉绘锛?/span>鐢峰コ鏈夊埆銆?/span>鍗虫偅鑰呮帴鍙椾笉鍚屾€у埆渚涗綋蹇冭剰绉绘鐨勫悗鏋滃瓨鍦ㄨ緝澶у尯鍒€傛帴鍙楀悓鎬у績鑴忕殑鎮ｈ€咃紝鏈悗鍑虹幇涓ラ噸鎺掑紓鍙嶅簲鐨勫嚑鐜囪緝浣庯紝涓€骞村唴瀛樻椿鐜囨瘮鎺ュ彈寮傛€у績鑴忕殑鎮ｈ€呴珮锛掞紣锛呫€?/span>涓庢帴鍙楀紓鎬т緵浣撳績鑴忕Щ妞嶇殑鐥呬汉鐩告瘮锛屾帴鍙楀悓鎬т緵浣撳績鑴忕殑鐥呬汉鏈悗绗竴骞村嚭鐜颁弗閲嶆帓寮傚弽搴旂殑鍑犵巼浣庯紤锛擄紖锛屽湪锛斿勾鍐呭嚭鐜颁弗閲嶆帓寮傚弽搴旂殑鍑犵巼浣庯紤锛?/span>锛呫€傛渶鎴愬姛鐨勫績鑴忓尮閰嶆槸鐢锋€т笌鐢锋€т箣闂寸殑蹇冭剰绉绘锛屾垚鍔熺巼鏈€浣庣殑鏄敺鎬у彈浣撴帴鍙楀コ鎬т緵浣撶殑蹇冭剰銆傚垎鏋愯涓猴紝涓庡績鑴忕Щ妞嶄腑鐨?span lang="EN-US">“鎬у埆宸紓”鏈夊叧鐨勫師鍥犲彲鑳芥槸鐢峰コ蹇冭剰澶у皬鍜屽厤鐤郴缁熺殑鍖哄埆浠ュ強鑽峰皵钂欐縺绱犵殑涓嶅悓銆?/span>鍥犳锛屽績鑴忕Щ妞嶆渶濂藉仛鍒?ldquo;渚涗綋鍙椾綋锛屾€у埆鍙婂ぇ灏忕浉閰?rdquo;銆?/span>浠ュ墠鐨勭爺绌跺彂鐜帮紝“鎬у埆宸紓”瀵硅偤銆佽偩鑴忕Щ妞嶆湁涓€瀹氬奖鍝嶃€傜湅鏉ユ槸“娈婅剰鍚屽綊”浜嗐€?span lang="EN-US">

鎹粺璁★紝缇庡浗濂虫偅鑰呯瓑寰呮墜鏈殑鏃堕棿骞冲潎涓猴紤锛愶紭澶╋紝鐢锋偅鑰呰繕闇€绛夊緟鏇撮暱鏃堕棿锛屼负锛戯紤锛欏ぉ锛岃€屼笖绛夊緟鎵嬫湳鐨勭敺鎮ｈ€呮暟閲忔瘮濂虫€у涓ゅ€嶃€傚彲瑙侊紝涓嶅皯鎮ｈ€呴兘涓嶅緱涓嶆帴鍙楀紓鎬т緵浣撳績鑴忋€傚敖绠℃帴鍙楀悓鎬т緵浣撳績鑴忕Щ妞嶇殑鏈悗鎴愬姛鐜囪緝楂橈紝涓撳浠苟涓嶅缓璁偅鑰呯壒鍦扮瓑鍊欏悓鎬т緵浣撳績鑴忥紝鍥犱负鍙婃椂鎵嬫湳鍏崇郴鎮ｈ€?span lang="EN-US">瀹夊嵄銆?span lang="EN-US">

鏈€鏂扮爺绌惰繕鏄剧ず锛屽熀鍥犳祴璇曡兘鎻愪緵蹇冭剰绉绘涔嬪悗鍣ㄥ畼宸ヤ綔鎯呭喌鐨勮缁嗕俊鎭€傜洰鍓嶇敤浜庡彇浠ｄ紶缁熺殑渚靛叆鎬у績鑲屾椿浣撶粍缁囧垏鐗囨妧鏈?/span>--GEP娴嬭瘯锛屽彲浠ョ洃鎺ф偅鑰呮槸鍚﹀绉绘鐨勫績鑴忎骇鐢熸帓寮傚弽搴斻€傛澶栵紝璇ユ妧鏈繕鍙互鍙嶆槧姘чケ鍜屽害銆佸績鑴忓帇鍔涘強蹇冭倢鐨勭數鎬ц川绛夛紝杩欎簺鎸囨爣瀵逛簬鍒嗘瀽绉绘鍚庡績鑴忕殑宸ヤ綔鎯呭喌鏄潪甯搁噸瑕佺殑銆?/span>

鍦ㄧ編鍥斤紝绾︽湁480涓囧悕蹇冨姏琛扮鎮ｈ€咃紝姣忓勾绾︽湁5涓囧悕缁堟湯鏈熷績鍔涜“绔偅鑰呮浜★紝鑰屾瘡骞村績鑴忕Щ妞嶇殑鎮ｈ€呬笉瓒?span lang="EN-US">2000渚嬨€傚湪鑻卞浗锛?span lang="EN-US">60宀佷互涓嬮渶杩涜蹇冭剰绉绘鐨勬偅鑰呬粎14渚嬶紝浠呮湁20%鑳借幏寰椾緵蹇冿紝鑰岀粷澶ч儴鍒嗘偅鑰呭洜寰椾笉鍒版晳娌昏€屼抚鐢熴€傚洜姝わ紝鐮斿彂浜哄伐蹇冭剰灏嗕负澶ч儴鍒嗙粓鏈湡蹇冭绠＄梾鎮ｈ€呭甫鏉ョ敓瀛樼殑鏇欏厜銆?span lang="EN-US">

浜哄伐蹇冭剰  閬ヨ繙涓嶅啀

浜哄伐蹇冭剰涓轰紬澶氬績鑴忕梾鎮ｈ€呭甫鏉ョ敓鐨勫笇鏈涖€?/span>

涓嶄粎鎮ｈ€呮湳鍚庤闇€瑕佷紤鎭紝蹇冭剰鏈韩涔熻浼戞伅銆傞噸绾?span lang="EN-US">8g涓存椂蹇冩车鍙娇蹇冭剰鎵嬫湳鍚庢偅鑰呮洿蹇悍澶嶃€傛湭鏉ワ紝杩欑鏂扮殑瑁呯疆鏈夊姪浜庢洿澶氭偅鑰呰櫄寮辩殑蹇冭剰鎰堝悎銆傝瑁呯疆鍩烘湰涓婂彲浠ユ墽琛屽績鑴?span lang="EN-US">2/3鐨勫姛鑳斤紝鍥犳锛屽彲浠ヨ蹇冭剰“鏆傛椂缃㈠伐”锛屼慨澶嶈嚜韬€傝繖绉嶅井鍨嬫车缃叆瀵肩锛岀粡鍔ㄨ剦瀵煎叆蹇冭剰锛堝乏瀹わ級锛屽彲浠ュ府鍔╁乏瀹ゆ车琛€銆傝璁＄殑鐩殑鏄绉戞墜鏈悗鏀寔蹇冭剰涓€鍛ㄦ垨鏇寸煭鏃堕棿锛岃蹇冭剰鏇村揩鎭㈠銆傜敱浜庢湁杩欑甯姪蹇冭剰搴峰鐨勬湁鍔涚殑杈呭姪娉碉紝鍙互杈冧互鍓嶆洿澶氬湴鏂借寮€鑳告墜鏈€備緥濡傛偅鑰呭彧闇€寰瀷娉佃緟鍔?span lang="EN-US">2澶╋紝蹇冭剰渚垮揩閫熸剤鍚堬紝澶уぇ缂╃煭浜嗘偅鑰呭悍澶嶆椂闂达紝鏈悗鎮ｈ€呭緢蹇氨鍙捣搴婃椿鍔ㄣ€傚井鍨嬪績娉垫渶澶氭瘡鍒嗛挓鍙互娉?span lang="EN-US">5鍗囪锛堢浉褰撴甯稿績鍗氶噺7鍗囩殑3/4銆傚緟瀹屾垚浣垮懡鍚庯紝鍙互浠庢偅鑰呬綋鍐呭幓闄ゆ娉点€?span lang="EN-US">

浠婂勾7鏈?/span>2鏃ワ紝涓€浣?/span>14宀佺編鍥藉コ鎬ф偅鑰呭湪绗竴娆″績鑴忕Щ妞嶆墜鏈け璐ュ悗锛屽尰鐢熶负杩欏悕鎽橀櫎浜嗗績鑴忕殑“鏃犲績浜?/span>”妞嶅叆浜嗕竴鍙版柊鍨嬩汉宸ュ績鑴忥紝鎮ｈ€呬緷闈犱汉宸ュ績鑴忓杩硅埇鍦板瓨娲讳簡118澶╋紝10鏈?/span>29鏃ュ尰鐢熺粓浜庝负鎮ｈ€呮垚鍔熺Щ妞嶄簡鍙︿竴棰楁柊蹇冭剰銆?/span>

浜哄伐蹇冭剰鏄寚鑳藉妞嶅叆浜轰綋鍐呯殑琛€娑叉车锛岄櫎浜嗘车浠ュ锛岃绯荤粺缁勬垚杩樺寘鎷洃娴嬩笌鎺у埗绯荤粺銆侀┍鍔ㄨ缃強鑳芥簮渚涚粰绯荤粺銆?/span>鎸夊叾鐢ㄩ€斿彲鍒嗕负宸﹀績瀹よ緟鍔┿€佸彸蹇冨杈呭姪銆佸弻蹇冨杈呭姪鍜屽叏浜哄伐蹇冭剰銆?/span>浜哄伐蹇冭剰灏氬緟绐佺牬鐨勫叧閿妧鏈富瑕佹湁蹇冭剰娉垫祦閬撶殑鐢熺悊鐩稿鎬ц璁°€佸熀浜庝汉浣撶敓鐗╀俊鎭殑绮剧‘鎺у埗銆侀珮鏁堢殑缁忕毊鑳芥簮渚涘簲绯荤粺绛夈€?/span>

杩戝勾锛岃嫳鍥界爺鍒剁殑鍏ㄧ悆棣栭鐢佃剳涓夌淮蹇冭剰妯″瀷鏈夋湜涓哄績鑴忔墜鏈甫鏉ュ彉闈┿€?ldquo;涓夌淮蹇?rdquo;鏈夋湜甯姪鍖荤敓缂╃煭蹇冭剰鎵嬫湳鏃堕棿銆佹彁楂樻墜鏈噯纭€э紝杩樺彲渚涘尰瀛﹂櫌瀛︾敓鎴栧疄涔犲尰鐢熷涔犲拰鐮旂┒鎵嬫湳娌荤枟鏂规銆傝€屾棩鏈爺鍒剁殑浜哄伐蹇冭剰“Everheart”妞嶅叆鎮ｈ€呬綋鍐呭悗锛?span lang="EN-US">6涓湀瀛樻椿鐜囬珮杈?span lang="EN-US">89%锛屼竴骞村瓨娲荤巼杈?span lang="EN-US">83%锛屾垚鏁堝彲涓庡績鑴忕Щ妞嶇浉鍖规晫銆傛渶鏂版姤閬擄紝涓栫晫棣栦釜鍙Щ妞嶄汉閫犲績鑴忓湪娉曞浗闂笘銆傝繖涓汉閫犲績鑴忎笌浜虹被蹇冭剰澶у皬鐩稿綋锛屾槸鍔ㄧ墿缁勭粐銆侀噾灞為挍鍜屽寮规妧鏈殑缁撳悎浣撱€傚畠鍙互瀹屽叏鏇夸唬浜虹被蹇冭剰銆?span lang="EN-US">

鍙﹀锛?/span>缇庡浗绉戝瀹剁敤姝诲幓灏忛紶鐨勫績鑴忕粍缁囩粨鏋?span lang="EN-US">,鍚戝叾涓敞鍏ュ煿鍏荤殑鏂扮敓缁嗚優,寰楀埌浜嗛噸鏂拌烦鍔ㄧ殑蹇冭剰銆?span lang="EN-US">“澶嶆椿”8澶╁悗,杩欎簺蹇冭剰鍔熻兘杈惧埌姝ｅ父灏忛紶蹇冭剰鍔熻兘鐨?span lang="EN-US">2%銆?/span>璺冲姩鐨勭敓鐗╀汉宸ュ績鑴?/span>灏嗕负浜虹被蹇冭绠″仴搴峰甫鏉ユ柊鐨勫笇鏈涖€?/span>

鎬讳箣锛屾湭鏉ョ殑浜哄伐蹇冭剰灏嗘洿鍙潬銆佹洿瀹夊叏銆佹洿瀹岀編銆傛垜鍥芥槸涓栫晫浜哄彛澶у浗锛岀粓鏈湡蹇冭剰鐥呮偅鑰呮暟閲忓簽澶э紝绉瀬鐮斿彂浜哄伐蹇冭剰鍏锋湁閲嶈鐨勭幇瀹炴剰涔夈€?/span>

寰垱澶栫  鎺ㄥ箍涓嶆槗

CABG鍦ㄥ啝蹇冪梾澶栫娌荤枟涓叿鏈変笉鍙姩鎽囩殑鍦颁綅锛屼絾浜︽湁鑷韩鐨勭己闄凤細锛?span lang="EN-US">1锛夐渶瑕佸紑鑳告墜鏈紱锛?span lang="EN-US">2锛夊垱浼よ緝澶э紱鑳稿墠8-10鑻卞鍒囧彛銆傚洜姝わ紝寰垱鎵嬫湳灏嗘垚涓烘柊鐨勫彂灞曟柟鍚戯紝鍙楀埌鍖绘偅闈掔潗銆?st1:chsdate w:st="on" isrocdate="False" islunardate="False" day="26" month="4" year="2008">2008骞?span lang="EN-US">4鏈?span lang="EN-US">26鏃?/st1:chsdate>ASA锛堢編鍥藉绉戝崗浼氾級128灞婂勾浼氭姤鍛婁簡鐗╃編浠峰粔鐨勬満鍣ㄤ汉杈呭姪鍐犺剦琛€杩愰噸寤恒€? 

鑷編鍥界航绾︿袱浣嶅尰鐢熷叡鍚屽畬鎴愮1渚嬫満鍣ㄤ汉锛?span lang="EN-US">DaVinci锛夎緟鍔?span lang="EN-US">CABG鏈互鏉ワ紝寰垱鎵嬫湳浠ュ叾涓€绯诲垪浼樺娍鍚稿紩蹇冨绉戝尰鐢熷拰鎮ｈ€呫€傛鍚庡畬鎴愮殑鏈哄櫒浜鸿緟鍔╁井鍒涘績鑴忔墜鏈紝鍖呮嫭锛?span lang="EN-US">1銆佹敹鑾蜂钩鍐呭姩鑴夛紱2銆佷簩灏栫摚淇锛?span lang="EN-US">3銆佺1渚嬫満鍣ㄤ汉杈呭姪鎴跨己(ASD)淇ˉ鏈€傚井鍒涙満鍣ㄤ汉杈呭姪鎵嬫湳鐨勪竴绯诲垪涓村簥璇曢獙宸茶幏FDA閫氳繃銆?span lang="EN-US">

鍏跺熀鏈柟娉曟槸鍦ㄦ偅鑰呰倠闂寸┛鍒?span lang="EN-US">3涓搮绗斿ぇ灏忕殑灏忓瓟锛?span lang="EN-US">2鍙満姊拌噦鍜屼竴涓唴绐ラ暅锛堝井鍨嬬浉鏈猴級鍙姷杈惧績鑴忥紝涓嶅紑鑳告柦琛屽績鑴忔墜鏈€傝繖鏄績澶栫鎵嬫湳鍙蹭笂鐨勫巻鍙叉€у垱鏂般€傚拰甯歌澶栫鎵嬫湳姣旇緝锛屽叾浼樺娍鏄樉鑰屾槗瑙佺殑锛屽寘鎷細

1銆佸彲鎻愬墠1-2澶╁嚭闄紝缂╃煭浣忛櫌鏃堕棿銆?span lang="EN-US">

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4銆佸苟鍙戠棁鏇村皯銆?span lang="EN-US">

5銆佹洿鏄撲繚鎸佹惌妗ヨ绠￠€氱晠銆?span lang="EN-US">

6銆佸甫鏉ヨ壇濂界粡娴庢晥鐩婏紙姣忎緥澧炲姞8鍗冪編鍏冿級銆?span lang="EN-US">

7銆佽妭鐪佹偅鑰呮€讳綋璐圭敤锛堢缉鐭綇闄紝鍑忓皯杈撹闇€瑕侊紝鍥犳湳鍚庡苟鍙戠棁杈冨皯锛岃€屽噺灏戝啀鍏ラ櫌锛屽挨鍏跺鏈夎偤鎴栬偩鐥呮垨鍏跺畠鍋ュ悍闂鐨勯珮鍗辨偅鑰咃紝寰垱鏈哄櫒浜哄绉戣妭鐪佽垂鐢級銆?

鍏蜂綋姣旇緝锛?span lang="EN-US">

鐩墠鐨勭己闄锋槸锛?span lang="EN-US">

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4銆侀渶瑕佺啛缁冩妧鏈殑蹇冨绉戝尰鐢熴€?

鏉備氦鎵嬫湳  鍐呭涓嶅垎

闅忕潃蹇冭剰澶栫娌荤枟鎶€鏈殑寰垱鍖栧拰鍖诲褰卞儚鎶€鏈殑鍙戝睍锛屽績鑴忓唴绉戞不鐤楃殑鏈夊垱鍖栭€愭鎴愪负鐜板疄銆傝瀺鍚堝績琛€绠″唴绉戝拰澶栫鎶€鏈紭鍔跨殑鏉備氦锛?/span>Hybrid锛?/span>鎶€鏈究搴旇繍鑰岀敓銆?/span>2004鍜?span lang="EN-US">2005骞?span lang="EN-US">AHA涓ゅ害鎶ュ憡锛岃仈鍚堟満鍣ㄤ汉杈呭姪CABG鍜屾敮鏋惰绠℃垚鍨嬫湳锛?span lang="EN-US">PCI锛夋樉绀轰簡鍐犲績鐥呭箍娉涚梾鍙樻不鐤楃殑鑹ソ鍓嶆櫙銆?span lang="EN-US">2004骞?span lang="EN-US">11鏈?span lang="EN-US">AHA鎶ュ憡锛岀1渚嬫潅浜ゆ墜鏈紝涓ょ鏂规硶鑱斿悎锛岄潪寮€鑳革紝蹇冭剰涓嶅仠璺虫儏鍐典笅瀹屾垚銆?span lang="EN-US">

寰垱鏂规硶鍙负鎮ｈ€呮湁鏁堟惌妗ユ垨寮€閫氬牭濉炵殑鍔ㄨ剦锛岀粨鏋滆緝寮€鑳告墜鏈鏈熺殑鏇村ソ鎴栦竴鏍峰ソ銆傛偅鑰呭钩鍧囦綇闄?span lang="EN-US">2.5澶╋紝鑰屽父瑙?span lang="EN-US">CABG闇€瑕?span lang="EN-US">5-6澶┿€傛仮澶嶅揩锛岀害1鍛ㄤ究鍙仮澶嶅伐浣滐紝鑰屽悗鑰呭父闇€6-12鍛ㄣ€傚叆閫夋偅鑰呮湁澶氭敮鍐犺剦鐥呭彉锛屽寘鎷細宸﹀墠闄嶆敮锛?span lang="EN-US">LAD锛夊拰宸︿富骞插牭濉炪€傚叏閮ㄦ搷浣滃厛鍦ㄥ唴绐ラ暅涓嬮棴鑳告惌妗ユ墜鏈紝鎺ョ潃琛€绠℃垚鍨嬫湳鐢ㄦ敮鏋舵拺寮€鏈牭濉炶绠°€傝繖绉嶆満鍣ㄤ汉杈呭姪鎵嬫湳鏄潪甯稿井鍒涚殑鏂规硶銆傚綋鐒讹紝蹇呴』寮鸿皟锛屾潅浜ゆ墜鏈洰鍓嶅彧鏄皬閲忥紙鏍锋湰锛夌爺绌讹紝涓斿叏鐞冧粎鏈夊皯鏁板嚑涓績鑴忎腑蹇冨彲浠ュ畬鎴愩€傚叾浼樼偣鍖呮嫭锛?span lang="EN-US">

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鍐嶇敓鍖诲  濂囪抗涓嶆柇

——鑴愬甫琛€鍙互甯姪寤洪€犳柊鐨勫績鑴忕摚鑶?span lang="EN-US">

涔濆崄骞翠唬鏈紝21涓栫邯鍒濅互骞茬粏鑳炰负鏍囧織鐨勫啀鐢熷尰瀛︾爺绌惰摤鍕冨彂灞曪紝灏ゅ叾蹇冭绠″熀纭€鐮旂┒涓庝复搴婂簲鐢ㄦ柟娉曢兘鍙栧緱浜嗘樉钁楄繘灞曘€?span lang="EN-US">

2008骞?span lang="EN-US">AHA骞翠細鎶ュ憡锛屽厛蹇冪梾鍎跨灏嗘湁鏈濅竴鏃ュ彲浠ュ埄鐢ㄤ粬浠嚜宸辩殑鑴愬甫琛€閲嶅缓瀹岀編鐨勬柊鐨勫績鑴忕摚鑶溿€傚綋鍑虹敓鏃跺績鑴忕摚鑶滅暩鍨嬬殑濠村効涓嶈兘澶栫鎵嬫湳淇锛屽氨鍙兘渚濋潬鍔ㄧ墿缁勭粐鐩稿鎬т汉绫诲櫒瀹樻崘鐚紝鎴栦汉宸ユ潗鏂欑疆鎹€傜疆鎹㈡墜鏈彲浠ユ尳鏁戠敓鍛斤紝浣嗙疆鎹㈢殑鐡ｈ啘涓嶈兘闅忕潃瀛╁瓙鐢熼暱鍙戣偛鑰屼竴鍚屽彉鍖栥€傚洜姝わ紝闇€瑕?span lang="EN-US">2娆℃垨鏇村鎵嬫湳鏇夸唬鐢熼暱鐨勭摚鑶溿€傚姩鐗╃粍缁囧彲鑳戒篃浼氬彉寰楀兊纭寲锛屼篃涓嶅姝ｅ父浜虹被鐡ｈ€愮敤锛岃€屼汉宸ョ摚鑶滅疆鎹㈡湳锛屽効绔ュ繀椤荤敤琛€鑶滄不鐤椼€傚洜姝?ldquo;濡傛灉浜у墠娴嬭瘯鏈夊績鑴忕己闄凤紝鍑虹敓鏃跺彲浠ユ敹闆嗚剱甯﹁锛岃串瀛樺共缁嗚優锛屼互澶囧┐鍎垮皢鏉ラ渶瑕佹椂鍒堕€犲績鑴忕摚鑶溿€?rdquo;

鐒惰€岋紝蹇冭剰鐡ｈ啘缁勭粐宸ョ▼浠嶅鍦ㄥ够鎯抽樁娈碉紝浼楀鐮旂┒浜哄憳姝ｅ湪鐮旂┒鐢ㄨ娑茬粏鑳炪€侀楂撶粏鑳炵殑鍙兘鎬с€備緥濡傦紝鑻卞浗涓€涓鐮斿皬缁勯娆℃垚鍔熺敤浠庝汉浣撻楂撲腑鎻愬彇鐨勫共缁嗚優鍩瑰吇鍑轰簡浜虹被蹇冭剰鐡ｈ啘銆?/span>

鍙︿竴椤圭爺绌朵腑锛岀爺绌跺皬缁勯噰鐢ㄨ剱甯﹁CD133+骞茬粏鑳炪€傝剱甯﹁鍐峰喕淇濆瓨锛?span lang="EN-US">12鍛ㄥ悗锛岃繖浜涘共缁嗚優琚妞嶅湪鐢熺墿闄嶈В鏉愭枡锛屾瀯寤虹殑8涓績鑴忕摚锛屽湪瀹為獙瀹や腑鐢熼暱銆傛鍚庯紝鐢甸暅妫€鏌ュ彂鐜帮紝杩欎簺骞茬粏鑳炵敓闀垮苟褰㈡垚缁勭粐灞傘€傜敓鍖栨鏌ユ樉绀猴紝缁嗚優涓嶄粎瀛樻椿銆佺敓闀匡紝鑰屼笖鍒嗘硨閲嶈鐨?ldquo;缁嗚優澶栧熀璐?rdquo;鎴愪唤——鏈轰綋缁勭粐缁勬垚閮ㄥ垎锛岃繖瀵逛簬缁勭粐鍔熻兘涓庣粨鏋勬槸蹇呰鐨勩€佸熀鏈殑銆傚拰浜轰綋鑲哄姩鑴夌粍缁囨瘮杈冿紝缁勭粐宸ョ▼鐡ｆ瀯鎴愬惈鏈夊悇绉嶈泲鐧斤紝鑰屼笖鐢ㄦ姉浣撴娴嬭繖浜涜泲鐧斤紝鐮旂┒浜哄憳鍙戠幇鐡ｈ啘鏈夎倢鑲夌粏鑳炶泲鐧姐€傝繖浜涙爣蹇楃墿琛ㄦ槑浜虹被蹇冭绠＄粍缁囧彲鍦ㄥ疄楠屽鐢熼暱銆?span lang="EN-US">

鐒惰€岋紝鍔熻兘鎬у績鑴忕摚鑶滅殑缁勭粐宸ョ▼鐨勫嚑涓噸瑕侀棶棰樹粛鏈夊緟浜庤В鍐筹紝鍖呮嫭纭鐞嗘兂鐨勬潗鏂欙紝浜嗚В鍦ㄥ疄楠屽濡備綍璋冩帶鐡ｈ啘锛屼究浜庣Щ妞嶅悗鏈夋晥宸ヤ綔銆?span lang="EN-US">

鎬讳箣缁勭粐宸ョ▼涓烘偅鑰呯粓鐢熸墍闇€锛屼笌鍙椾綋鍚岀敓闀夸綔鐢紝骞舵敼鍙樻墍闇€褰㈢姸鐨勭悊鎯崇殑蹇冭剰鐡ｈ啘鏇夸唬鐗╁甫鏉ュ墠鏅€?span lang="EN-US">  

蹇冭剰楹婚唹  杩涘睍涓嶅揩锛?span lang="EN-US">

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寰垱鑳稿鎵嬫湳鍜屾竻閱掗夯閱夊彲浠ユ垚灏卞垱鏂扮殑鎼ˉ澶栫鎵嬫湳锛岄€夋嫨娓呴啋楹婚唹琛?span lang="EN-US">MIDCAB鏈紝鏄渶鏂扮殑寰垱銆傛偅鑰呯浜屽ぉ鍗冲彲鍥炲锛屽彧闇€浣忛櫌5澶╁瘑鍒囪瀵燂紝鑰屾満鍣ㄤ汉鍐呴暅鎼ˉ锛屾竻閱掗夯閱夎幏鐩婃洿澶с€傚畠浠ｈ〃蹇冭兏澶栫闈炲父閲嶈鐨勮繘姝ワ紝鏇村畨鍏ㄣ€佽垂鏁堟瘮鍊兼洿濂姐€?span lang="EN-US">

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