急性心力衰竭急诊早期诊断与治疗新进展
New Advances in Early Diagnosis and Treatment of Acute Heart Failure
摘要: 急性心力衰竭(Acute Heart Failure, AHF)是急诊科常见的心血管急危重症,具有起病急、病情进展快及病死率高等特点。近年来,随着对AHF病理生理机制认识的不断深入及循证医学证据的持续积累,其急诊管理理念逐渐由单纯缓解症状向早期识别、精准诊断、快速减充血、优化血流动力学支持及早期启动指南指导药物治疗(Guideline-Directed Medical Therapy, GDMT)的综合管理模式转变。本文结合近年来相关研究进展,围绕AHF急诊早期评估与快速诊断策略、床旁超声及心脏生物标志物的应用,以及呼吸支持、精准减充血、血流动力学支持和GDMT早期启动等治疗策略进行综述。同时,对未来精准诊疗的发展方向进行展望,以期为AHF急诊规范化诊疗提供参考。
Abstract: Acute heart failure (AHF) is one of the most common cardiovascular emergencies encountered in the emergency department and is characterized by rapid disease progression, high hospitalization rates, and poor prognosis. In recent years, advances in the understanding of AHF pathophysiology and the accumulation of evidence-based medicine have shifted emergency management from symptom relief alone to a comprehensive strategy emphasizing early recognition, rapid diagnosis, precise decongestion, optimized hemodynamic support, and early initiation of guideline-directed medical therapy (GDMT). This review summarizes recent advances in research, focusing on early assessment and rapid diagnostic strategies for AHF, the application of point-of-care ultrasound and cardiac biomarkers, and therapeutic strategies including respiratory support, precision decongestion, hemodynamic support, and early initiation of GDMT. Future directions in precision diagnosis and treatment are also discussed, with the aim of providing a reference for the standardized emergency management of patients with AHF.
文章引用:隋宝帅, 王震. 急性心力衰竭急诊早期诊断与治疗新进展[J]. 临床医学进展, 2026, 16(9): 134-142. https://doi.org/10.12677/acm.2026.1693029

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