【健康科普】心力衰竭病人怎么样预防病情恶化？医生提醒：养成健康的生活方式
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;">心力衰竭（</span>HF）<span style="color: black;">是由于</span>心脏泵血功能失常<span style="color: black;">导致</span>，<span style="color: black;">引起</span>心脏难以<span style="color: black;">供给</span>满足全身的<span style="color: black;">基本</span>代谢<span style="color: black;">必须</span>的血液，<span style="color: black;">从而</span><span style="color: black;">诱发</span>血液循环问题的<span style="color: black;">疾患</span>。心肌梗死、心肌病、心肌炎等<span style="color: black;">疾患</span>都可能诱发心力衰竭，70岁以上的老年人是高危群体。<span style="color: black;">根据</span>病变部位，可将心衰分为左心衰竭、右心衰竭和全心衰竭。“心力衰竭的<span style="color: black;">重点</span>症状<span style="color: black;">包含</span><span style="color: black;">呼气</span>困难、人体活动受限和体液潴留等，加剧时还可能会<span style="color: black;">显现</span>肺部淤血、气促、胸闷、双下肢水肿、乏力和<span style="color: black;">头昏</span>等</span><span style="color: black;">症状</span><span style="color: black;">。”</span><span style="color: black;">景德镇</span><span style="color: black;">市第三人民医院心内科副<span style="color: black;">专家</span>医师邓婷婷说。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/peEMImR0N6g5z9BYAdDKtcjoLEEc0kDUibFgMXhXnvVomrTegRb2qplz6MT85Qgm8XicvDWLb0CFoIfHFpicSujaw/640?wx_fmt=jpeg&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">心力衰竭的基本原理</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/bL2iaicTYdZn5q27dTOdHYicicWnJ4BmicN90D2PS9aKTWH4TsGkFANUxZDbqOpx5Oz38Kao3WCKB0L1gzdDY6OTa9g/640?wx_fmt=png&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心脏是人体的血泵，<span style="color: black;">每日</span>日夜<span style="color: black;">一直</span>把<span style="color: black;">饱含</span>养分和氧气的血液泵到人体各处。<span style="color: black;">倘若</span>心脏功能<span style="color: black;">出现</span><span style="color: black;">反常</span>，就会<span style="color: black;">引起</span>人体血液循环不充分，血液<span style="color: black;">不可</span>满足各器官组织代谢<span style="color: black;">必须</span>，<span style="color: black;">亦</span>难以顺利地回流到心脏，这<span style="color: black;">便是</span>心力衰竭，简<span style="color: black;">叫作</span>心衰。我国心衰患病率约为1%，随人的年龄的增长而<span style="color: black;">增多</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 邓婷婷介绍，</span><span style="color: black;">左心负责输出充满养分和氧气的血液，<span style="color: black;">经过</span>血管系统<span style="color: black;">传送</span>到身体各处；右心则负责将带着二氧化碳等废物的血液<span style="color: black;">传送</span>回心脏。左心衰竭<span style="color: black;">便是</span>心脏送血功能<span style="color: black;">显现</span><span style="color: black;">阻碍</span>，<span style="color: black;">引起</span>带着氧气和养分的血液在<span style="color: black;">咱们</span>的肺部堆积。<span style="color: black;">因此呢</span>，左心衰竭的表现多为肺淤血的<span style="color: black;">关联</span>症状。而右心衰竭则是<span style="color: black;">因为</span>人体各处的血液回流心脏<span style="color: black;">显现</span><span style="color: black;">阻碍</span>，在人的<span style="color: black;">身体</span>淤积，表现为体循环（如四肢、肝肾脑等）淤血。单纯左心衰竭和右心衰竭，都会<span style="color: black;">引起</span><span style="color: black;">另一</span>一半心脏功能<span style="color: black;">逐步</span><span style="color: black;">出现</span><span style="color: black;">阻碍</span>，如不<span style="color: black;">即时</span><span style="color: black;">干涉</span>，有可能<span style="color: black;">引起</span><span style="color: black;">出现</span>更为严重的全心衰竭，<span style="color: black;">从而</span><span style="color: black;">引起</span>死亡。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/peEMImR0N6g5z9BYAdDKtcjoLEEc0kDUvk1fP4Zuj0ZiaaljWtiaGbkSsqJbkds2htKKSiaib6qKEBB1nlibpXOMuiaw/640?wx_fmt=jpeg&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">心力衰竭是慢性、自发<span style="color: black;">发展</span>性<span style="color: black;">疾患</span>，病情会<span style="color: black;">逐步</span>恶化，其死亡率高、预后不良。积极治疗可能<span style="color: black;">导致</span>心衰的<span style="color: black;">基本</span>心脏<span style="color: black;">疾患</span>，有利于延缓病情发展、<span style="color: black;">加强</span>心衰<span style="color: black;">病人</span>生活质量、降低该<span style="color: black;">疾患</span>的死亡率。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">任何<span style="color: black;">损害</span>心肌或影响心脏泵血的<span style="color: black;">原因</span>都会<span style="color: black;">引起</span>心力衰竭。心衰最<span style="color: black;">平常</span>病<span style="color: black;">由于</span>高血压和冠心病，还有瓣膜性<span style="color: black;">疾患</span>、心肌炎、先天性心脏病、遗传性心肌病、糖尿病、甲亢等。心衰的诱发<span style="color: black;">原因</span>有感染、<span style="color: black;">心率</span>失常、<span style="color: black;">疲劳</span>、体液负荷<span style="color: black;">增多</span>、原有心脏病恶化、用药<span style="color: black;">欠妥</span>等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_gif/Ljib4So7yuWjqp7ibVoRPAdAvoyUcCwvCP9Yyj67icxibITyic7dkDvl8Xv1ffvj6vq90dsvr6eAbS9KRiaaHL3EKGcQ/640?wx_fmt=gif&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">心力衰竭的<span style="color: black;">重点</span>症状</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/bL2iaicTYdZn5q27dTOdHYicicWnJ4BmicN90D2PS9aKTWH4TsGkFANUxZDbqOpx5Oz38Kao3WCKB0L1gzdDY6OTa9g/640?wx_fmt=png&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 心力衰竭<span style="color: black;">重点</span>症状有<span style="color: black;">那些</span>呢？邓婷婷介绍，</span><span style="color: black;"><span style="color: black;">首要</span>是<span style="color: black;">呼气</span>困难。心衰<span style="color: black;">病人</span>发病时会感觉上气不接下气，病情较轻的<span style="color: black;">病人</span>仅在体力活动后<span style="color: black;">显现</span><span style="color: black;">呼气</span>困难，<span style="color: black;">休憩</span>后可缓解。严重的<span style="color: black;">休憩</span>时<span style="color: black;">亦</span>感到<span style="color: black;">呼气</span>困难，<span style="color: black;">乃至</span>会在熟睡时<span style="color: black;">忽然</span>憋醒，感到窒息，被迫坐起，咳嗽<span style="color: black;">或</span>咳出粉红色<span style="color: black;">泡泡</span>痰。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 其次是乏力、疲倦、心慌、<span style="color: black;">头昏</span>等不适。这是<span style="color: black;">因为</span>心脏泵血<span style="color: black;">不可</span>满足各组织器官的<span style="color: black;">必须</span><span style="color: black;">导致</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 还有双下肢水肿、腹胀、食欲<span style="color: black;">衰退</span>等症状，这是<span style="color: black;">因为</span>血液<span style="color: black;">不可</span>顺利回流到心脏，<span style="color: black;">引起</span>心衰<span style="color: black;">病人</span><span style="color: black;">显现</span>身体低垂部位（如双下肢）水肿，胃肠道淤血<span style="color: black;">引起</span>腹胀、食欲<span style="color: black;">衰退</span>等<span style="color: black;">状况</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/peEMImR0N6g5z9BYAdDKtcjoLEEc0kDULBkxGK9koosL8m3Nd8ibd0XYNg2nM9hAMduZMibN3DnU6UrPXRfcoI4g/640?wx_fmt=jpeg&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">患</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">者如未接受治疗或疗效<span style="color: black;">不良</span>，心衰会逐步进行性加重，<span style="color: black;">引起</span>全身血液循环产生<span style="color: black;">阻碍</span>、人体各组织器官血供不足，<span style="color: black;">从而</span><span style="color: black;">引起</span>全身各器官的损害乃至坏死，如肾衰竭、肺淤血、四肢水肿等，<span style="color: black;">最后</span>发展成死亡。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"> 邓婷婷说，</span><span style="color: black;">医学上对心脏功能的健康程度进行了四级分级，分别是I级：能随便活动（<span style="color: black;">平常</span>活动不受限）；</span><span style="color: black;">Ⅱ级</span><span style="color: black;">：大动就犯病（体力活动时<span style="color: black;">导致</span>胸闷等不适）；III级：小动都犯病（<span style="color: black;">通常</span>活动时）；</span><span style="color: black;">Ⅳ级</span><span style="color: black;">：不动<span style="color: black;">亦</span>犯病（<span style="color: black;">休憩</span>时）。分级越高，症状越重，病情<span style="color: black;">亦</span>就越危险，但I-</span><span style="color: black;">Ⅳ级</span><span style="color: black;">都有猝死的<span style="color: black;">危害</span>，<span style="color: black;">不可</span><span style="color: black;">由于</span>分级不高就掉以轻心。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_gif/Ljib4So7yuWjqp7ibVoRPAdAvoyUcCwvCP9Yyj67icxibITyic7dkDvl8Xv1ffvj6vq90dsvr6eAbS9KRiaaHL3EKGcQ/640?wx_fmt=gif&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">心力衰竭的治疗</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/bL2iaicTYdZn5q27dTOdHYicicWnJ4BmicN90D2PS9aKTWH4TsGkFANUxZDbqOpx5Oz38Kao3WCKB0L1gzdDY6OTa9g/640?wx_fmt=png&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">心衰的病因不同，其治疗<span style="color: black;">办法</span><span style="color: black;">亦</span>不<span style="color: black;">同样</span>。对<span style="color: black;">诱发</span>心衰的冠心病、高血压、糖尿病等<span style="color: black;">疾患</span>应尽早治疗，<span style="color: black;">掌控</span>心脏部位的感染，改善心率，减轻心脏负荷等。而在日常生活中，要<span style="color: black;">促进</span><span style="color: black;">病人</span>养成有益于心脏健康的<span style="color: black;">膳食</span>习惯，少吃高盐、高脂肪<span style="color: black;">食品</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/peEMImR0N6g5z9BYAdDKtcjoLEEc0kDUBWM5pNp7brohBtrq0kcZ1SE7hxZtUpMR55LnoB4OpmqTgfpNmlEictQ/640?wx_fmt=jpeg&from=appmsg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">针对</span>病情严重的心衰<span style="color: black;">病人</span>，应<span style="color: black;">按照</span>GDMT维持和优化治疗，ARNI或ACEI/ARB、β受体阻滞剂、醛固酮受体拮抗剂、钠葡萄糖共转运蛋白2<span style="color: black;">控制</span>剂这四类药，被</span><span style="color: black;"><span style="color: black;">叫作</span>为</span><span style="color: black;">心衰治疗的“新四联”。<span style="color: black;">另一</span>，还有利尿剂、正性肌力<span style="color: black;">药品</span>、维利西胍、伊伐布雷定等<span style="color: black;">必须</span><span style="color: black;">按照</span><span style="color: black;">病人</span>的血压、心率及</span><span style="color: black;">并发症</span><span style="color: black;"><span style="color: black;">状况</span>来<span style="color: black;">调节</span>用药，绝对<span style="color: black;">不可</span>擅自停药。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另外</span>，还<span style="color: black;">能够</span>借助心脏起搏器、<span style="color: black;">移植</span>除颤器等医疗器械对心脏再同步化治疗，或直接进行心脏移植。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_gif/Ljib4So7yuWhyYicmNo0xKQr5ZkyUvpnUgoP0DBujOZFWkunMtvsV0WoH30cDFcdkOxgbVic8WuiafaAxzUeQxoqZA/640?wx_fmt=gif&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">心力衰竭<span style="color: black;">病人</span>小贴士</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一天之内体重<span style="color: black;">增多</span>1<span style="color: black;">千克</span>或<span style="color: black;">1星期</span>之内<span style="color: black;">增多</span>2.5<span style="color: black;">千克</span>；气短；下肢水肿<span style="color: black;">乃至</span>全身浮肿；<span style="color: black;">始终</span>感觉疲惫，<span style="color: black;">乃至</span><span style="color: black;">不可</span>进行正常活动；胃部</span><span style="color: black;">胀满感</span><span style="color: black;">；平卧时<span style="color: black;">呼气</span>困难；频繁咳嗽或咳粉红色<span style="color: black;">泡泡</span>痰等症状<span style="color: black;">显现</span>时，应立即<span style="color: black;">看病</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">应限制心衰<span style="color: black;">病人</span>参加体力劳动，较严重的<span style="color: black;">病人</span>应<span style="color: black;">尽可能</span>卧床<span style="color: black;">休憩</span>治疗，待心功能改善后方可下床活动，<span style="color: black;">以避免</span>产生下肢血栓或肺部感染。<span style="color: black;">身患</span>心衰或<span style="color: black;">相关</span><span style="color: black;">疾患</span>的育龄<span style="color: black;">女性</span>，应采取避孕<span style="color: black;">办法</span>。心衰<span style="color: black;">病人</span>应终身服药，绝对不可<span style="color: black;">自动</span>停药，<span style="color: black;">以避免</span>病情反复，<span style="color: black;">引起</span>多次住院、<span style="color: black;">疾患</span>加剧<span style="color: black;">乃至</span>死亡。<span style="color: black;">同期</span>，应养成健康的生活方式，<span style="color: black;">掌控</span>钠盐摄入以避免水钠潴留，低脂<span style="color: black;">膳食</span>、避免就餐过饱以<span style="color: black;">掌控</span>体重。戒烟，避免过量饮酒，适当<span style="color: black;">熬炼</span>。<span style="color: black;">保准</span>充足<span style="color: black;">睡觉</span>、保持良好<span style="color: black;">心情</span>，积极预防<span style="color: black;">呼气</span>道感染，从而降低心衰<span style="color: black;">爆发</span>的<span style="color: black;">危害</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">得了心衰<span style="color: black;">亦</span><span style="color: black;">不消</span>害怕，要保持<span style="color: black;">自信心</span>和<span style="color: black;">期盼</span>。邓婷婷提示，只要<span style="color: black;">保持</span>系统、规范地治疗，心衰<span style="color: black;">病人</span>是<span style="color: black;">能够</span>正常工作和生活的。</p>
<span style="color: black;"><strong style="color: blue;"><span style="color: black;">景德镇市第三人民医院</span></strong></span><span style="color: black;"><strong style="color: blue;"><span style="color: black;"> 心血管内科咨询<span style="color: black;">tel</span>：</span></strong></span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">0798——8417450</span></strong></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">外链论坛：http://www.fok120.com/曹嘉琪</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">校 对：华永平</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一 审：宋 波</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">二 审：宋悦文</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">三 审：张俐虹</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">文稿<span style="color: black;">源自</span>：心血管内科 邓婷婷</span></p>
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