Palliative care in end-stage valvular heart disease.
Palliative care in end-stage valvular heart disease.
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DOI：
10.1136/heartjnl-2016-310538
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发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Kirkpatrick JN
中科院分区：
文献类型：
--
作者：
Steiner JM;Cooper S;Kirkpatrick JN
瓣膜性心脏病（VHD），尤其是主动脉瓣疾病，发病率越来越高。当手术不可能，或当风险大于收益时，经皮治疗方案可能提供有效的替代方案。然而，手术可能并不总是按计划进行，虚弱的患者或那些症状由其他合并症引起的患者可能根本不会从瓣膜介入手术中受益。在干预之前，应该做出重大努力来评估虚弱、合并症和患者目标。姑息治疗（PC）应在重症瓣膜疾病患者的护理中发挥关键作用。PC是一种专门的医疗护理，旨在通过管理症状和澄清患者的价值观和护理目标来优化与健康相关的生活质量。它应在诊断时实施，并在整个病程中持续进行。由于缺乏专门为晚期VHD患者提供PC的研究，因此需要进一步的研究。
Valvular heart disease (VHD), particularly aortic valve disease, is prevalent with increasing incidence. When surgery is not possible, or when risks outweigh benefits, percutaneous treatment options may offer effective alternatives. However, procedures may not always go as planned, and frail patients or those whose symptoms are caused by other comorbidities may not benefit from valve intervention at all. Significant effort should be made to assess frailty, comorbidities and patient goals prior to intervention. Palliative care (PC) should play a critical role in the care of patients with severe valve disease. PC is specialised medical care that aims to optimise health-related quality of life by managing symptoms and clarifying patient values and goals of care. It should be implemented at the time of diagnosis and continue throughout the disease course. Because of the paucity of studies dedicated to the provision of PC to patients with advanced VHD, further research is needed.
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