心力衰竭的症状和体征
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力衰竭<span style="color: black;">指的是</span><span style="color: black;">因为</span>心肌收缩力下降<span style="color: black;">引起</span>心排血量不足使机体受损的综合症。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">特点是淤血和组织灌注不足,又叫充血性心力衰竭。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力衰竭的<span style="color: black;">原由</span>分为心肌本身的病变和心室负荷过重,心肌缺血、心肌坏死、心肌炎症为前者;高血压、主动脉瓣狭窄、等为后者。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力衰竭除了基本病因还有诱因<span style="color: black;">例如</span>感染、输液过快等<span style="color: black;">增多</span>心脏负荷使病情加重。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">左心衰竭症状为乏力、劳力性<span style="color: black;">呼气</span>困难、夜间阵发性<span style="color: black;">呼气</span>困难、端坐<span style="color: black;">呼气</span>、咳嗽、<span style="color: black;">泡泡</span>痰,<span style="color: black;">少许</span>有咯血。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">右心衰竭症状为腹胀、少尿和食欲不振,<span style="color: black;">乃至</span>恶心呕吐。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">左心衰竭的体征<span style="color: black;">重点</span>为肺淤血。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">视诊<span style="color: black;">发掘</span>病人有<span style="color: black;">呼气</span>急促、发绀、高枕卧位、端坐体位。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺水肿时有<span style="color: black;">海量</span>粉红色<span style="color: black;">泡泡</span>痰、<span style="color: black;">呼气</span>窘迫、大汗淋漓。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">触诊<span style="color: black;">发掘</span>交替脉。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">听诊<span style="color: black;">发掘</span>心率增快,心尖区舒张奔马律,肺动脉瓣第二心音亢进。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">有细小湿啰音,哮鸣音;肺水肿时双肺布满湿啰音哮鸣音。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">右心衰竭体征<span style="color: black;">重点</span>是体循环系统淤血。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">视诊<span style="color: black;">发掘</span>病人颈静脉怒张、有<span style="color: black;">周边</span>性发绀,水肿。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">触诊<span style="color: black;">发掘</span>肝肿大、压痛和肝颈静脉回流征阳性。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">下垂部位凹陷性水肿,严重者全身水肿。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">叩诊<span style="color: black;">发掘</span>胸腹腔积液。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">听诊<span style="color: black;">发掘</span>三尖瓣区相对关闭不全的收缩期吹风样杂音,和右心室舒张期奔马律。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">还有原发性心脏病变和心力衰竭诱因症状体征。</p>
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