不稳定性心绞痛

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1、ClinicalpathwayofInterventionaltherapybasedonUnstableAnginaA.Standardhospitalizationprocess(a)ApplicableobjectivesThefirstdiagnosisisunstableAngina（ICD-10：I20.0/20.1/20.9）Underwentcoronarystenting（ICD-9-CM-3：36.06/36.07）(b)Diagnosisbasis《ClinicalPracticeGuidelines-DepartmentofCardiology》（

2、EditedbyChineseMedicalAssociation,People'sHealthPublishingdepartment,2009),《UnstableAnginaandnon-ST-segmentelevationmyocardialinfarctiondiagnosisandtreatmentguidelines》(CardiologyBranchofChineseMedicalAssociation,2007)andthe2007ACC/AHAandESCguidelines.1.Characteristicsofclinicalonset:thec

3、linicalmanifestationisExercise-inducedchestpainorSpontaneouschestpain,itwillbequicklyrelievedwhentakearestorsublingualadministrationofnitroglycerin.2.TheECG:ST-segmentdepressionorelevation>0.1mVonadjacenttwoormorethantwo-leadECGorT-waveinversion≥0.2mVwhenchestpainisonset,thechangesinST-Ts

4、egmentrecoveritselfwhenthechestpaingetrelieved.3.Markersofmyocardialinjuryarenotelevatedornotreachthelevelofdiagnosisofmyocardialinfarction1.Clinicaltypes1)Initialonsetofangina:thenew-occurredangina,whichhasthelargestdiseasecourseofamonth,canbemanifestedasSpontaneousandexertionalanginaons

5、etexistatthesametime,andthepaingradingisabovelevelIII.2)Worseningexertionalangina:patienthasaanginahistory,andtheanginagetworsened,itattacksfrequently,andtheonsettimeisbecominglongerandlonger,thepainthresholdisgettinglowerandlower(Canadaexertionalanginagrade[CCSI-IV]increasedbyatleastonec

6、lassorreachedatleastClassIII)3)Restingangina:anginaattackswhenpatientsareatrestorataquietstate,andseizuredurationisusuallymorethan20minutes.4)Postinfarctionangina:itreferstotheanginaoccurredbetween24hoursandamonthaftertheonsetofacutemyocardialinfarction.5)Variantangina:theanginaattackswh

7、enthepatientsareatrestorengagedingeneralactivities,electrocardiogramshowedatransientelevationoftheSTsegmentwhenanginaisonset,mostpatientswillrecoverautomatically,whileafewpatientsgetevolvedintomyocardialinfarction.（C）Therapyselectionandbasis《ClinicalPracticeGuidelin