| 词条 | External counterpulsation |
| 释义 |
| name = External counterpulsation | synonym = Enhanced external counterpulsation (EECP) | image = Blausen 0161 Cardiac Enhanced External Counterpulsation.png | caption = Illustration showing cardiac external counterpulsation | alt = | pronounce = | specialty = | synonyms = | ICD10 = | ICD9 = | ICD9unlinked = | CPT = | MeshID = | LOINC = | other_codes = | MedlinePlus = | eMedicine = }} External counterpulsation therapy (ECP) is a procedure that may be performed on individuals with angina, heart failure, or cardiomyopathy. Medical usesSome reviews did not find sufficient evidence that it was useful for either angina or heart failure.[1][2] Other reviews found tentative benefit in those with angina that does not improve with medications.[3][4] For stroke due to lack of blood flow a 2012 Cochrane review found insufficient evidence to make conclusions.[5] MethodWhile an individual is undergoing ECP, he/she has pneumatic cuffs on his or her legs and is connected to telemetry monitors that monitor heart rate and rhythm. The most common type in use involves three cuffs placed on each leg (on the calves, the lower thighs, and the upper thighs (or buttock)). The cuffs are timed to inflate and deflate based on the individual's electrocardiogram. The cuffs should ideally inflate at the beginning of diastole and deflate at the beginning of systole. During the inflation portion of the cycle, the calf cuffs inflate first, then the lower thigh cuffs and finally the upper thigh cuffs. Inflation is controlled by a pressure monitor, and the cuffs are inflated to about 200 mmHg. Physiological considerationsOne theory is that ECP exposes the coronary circulation to increased shear stress, and that this results in the production of a cascade of growth factors that result in angiogenesis.[6] References1. ^{{cite journal|last1=McKenna|first1=C|last2=McDaid|first2=C|last3=Suekarran|first3=S|last4=Hawkins|first4=N|last5=Claxton|first5=K|last6=Light|first6=K|last7=Chester|first7=M|last8=Cleland|first8=J|last9=Woolacott|first9=N|last10=Sculpher|first10=M|title=Enhanced external counterpulsation for the treatment of stable angina and heart failure: a systematic review and economic analysis.|journal=Health technology assessment (Winchester, England)|date=April 2009|volume=13|issue=24|pages=iii-iv, ix-xi, 1–90|doi=10.3310/hta13240|pmid=19409154}} {{DEFAULTSORT:Enhanced External Counterpulsation}}2. ^{{cite journal|last1=Amin|first1=F|last2=Al Hajeri|first2=A|last3=Civelek|first3=B|last4=Fedorowicz|first4=Z|last5=Manzer|first5=BM|title=Enhanced external counterpulsation for chronic angina pectoris.|journal=The Cochrane Database of Systematic Reviews|date=17 February 2010|issue=2|pages=CD007219|doi=10.1002/14651858.CD007219.pub2|pmid=20166092}} 3. ^{{cite journal|last1=Soran|first1=O|title=Alternative therapy for medically refractory angina: enhanced external counterpulsation and transmyocardial laser revascularization.|journal=Cardiology clinics|date=August 2014|volume=32|issue=3|pages=429–38|doi=10.1016/j.ccl.2014.04.009|pmid=25091968}} 4. ^{{cite journal|last1=Qin|first1=X|last2=Deng|first2=Y|last3=Wu|first3=D|last4=Yu|first4=L|last5=Huang|first5=R|title=Does Enhanced External Counterpulsation (EECP) Significantly Affect Myocardial Perfusion?: A Systematic Review & Meta-Analysis.|journal=PLoS ONE|date=2016|volume=11|issue=4|pages=e0151822|doi=10.1371/journal.pone.0151822|pmid=27045935|pmc=4821484}} 5. ^{{cite journal|last1=Lin|first1=S|last2=Liu|first2=M|last3=Wu|first3=B|last4=Hao|first4=Z|last5=Yang|first5=J|last6=Tao|first6=W|title=External counterpulsation for acute ischaemic stroke.|journal=The Cochrane Database of Systematic Reviews|date=18 January 2012|volume=1|pages=CD009264|doi=10.1002/14651858.CD009264.pub2|pmid=22259001}} 6. ^{{cite journal |vauthors=Soran O, Crawford LE, Schneider VM, Feldman AM |title=Enhanced external counterpulsation in the management of patients with cardiovascular disease |journal=Clin Cardiol |volume=22 |issue=3 |pages=173–8 |date=March 1999 |pmid=10084058 |doi=10.1002/clc.4960220304 }} {{cite journal |vauthors=Manchanda A, Soran O |title=Enhanced external counterpulsation and future directions: step beyond medical management for patients with angina and heart failure |journal=J. Am. Coll. Cardiol. |volume=50 |issue=16 |pages=1523–31 |date=October 2007 |pmid=17936150 |doi=10.1016/j.jacc.2007.07.024 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)02392-3}} 1 : Cardiac procedures |
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