心衰的最佳治疗办法？
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><a style="color: black;">心衰</a></span>，<span style="color: black;">亦</span><span style="color: black;">便是</span>心力衰竭，是一种慢性病，除了<span style="color: black;"><a style="color: black;">心脏移植手术</a></span>，<span style="color: black;">日前</span>尚<span style="color: black;">没</span>根治的<span style="color: black;">办法</span>。<span style="color: black;">因此呢</span>心力衰竭的治疗，目的在于减少心力衰竭复发，<span style="color: black;">掌控</span>心力衰竭<span style="color: black;">发展</span>、延长生命。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1、针对病因进行治疗，<span style="color: black;">亦</span><span style="color: black;">便是</span>搞清楚<span style="color: black;">引起</span>心力衰竭<span style="color: black;">出现</span>的<span style="color: black;">详细</span>病因，并进行针对性治疗，改善<span style="color: black;"><a style="color: black;">心脏功能</a></span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2、对心力衰竭本身进行<span style="color: black;">掌控</span>，<span style="color: black;">包含</span><span style="color: black;">长时间</span>的<span style="color: black;"><a style="color: black;"><span style="color: black;">药品</span>治疗</a></span>，和心脏<span style="color: black;">移植</span>型电子器械治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 1）<span style="color: black;">长时间</span>的<span style="color: black;">药品</span>治疗：如醛固酮受体拮抗剂、<span style="color: black;"><a style="color: black;">β受体阻滞剂</a></span>、ACEI或ARB类<span style="color: black;">药品</span>、利尿剂、脑啡肽酶<span style="color: black;">控制</span>剂、伊伐布雷定、地高辛、SGLT2<span style="color: black;">控制</span>剂、维利西呱等，而不同各类型的心力衰竭用药<span style="color: black;">亦</span>有所不同，<span style="color: black;">详细</span>用药<span style="color: black;">方法</span>需<span style="color: black;">按照</span><span style="color: black;">病人</span>病情由专科<span style="color: black;">大夫</span><span style="color: black;">调节</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 2）心脏<span style="color: black;">移植</span>型电子器械：<span style="color: black;">重点</span>是<span style="color: black;"><a style="color: black;">心脏再同步化治疗</a></span>器械（CRT）、心脏除颤器械（ICD）<a style="color: black;"></a>，前者用于纠正心力衰竭<span style="color: black;">病人</span>的<span style="color: black;"><a style="color: black;">心脏失同步</a></span>以改善心力衰竭，后者用于<span style="color: black;">帮忙</span>心力衰竭<span style="color: black;">病人</span>预防<span style="color: black;"><a style="color: black;">心脏性猝死</a></span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">日前</span>心力衰竭治疗器械已在技术和<span style="color: black;">办法</span>上取得了巨大的<span style="color: black;">发展</span>，使越来越多的心力衰竭<span style="color: black;">病人</span>从中获益，但每种器械<span style="color: black;">也</span>存在其缺点，需<span style="color: black;">按照</span><span style="color: black;">病人</span>的临床特点、经济<span style="color: black;">前提</span>等<span style="color: black;">选取</span>最佳治疗器械<a style="color: black;"></a>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3、<span style="color: black;">平常</span>生活管理，减轻心脏<span style="color: black;">包袱</span>，这<span style="color: black;">针对</span>心力衰竭<span style="color: black;">病人</span><span style="color: black;">来讲</span>非常<span style="color: black;">重要</span>，<span style="color: black;">包含</span>但不限于以下几条：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1）改善习惯：<span style="color: black;">平常</span><span style="color: black;"><a style="color: black;">低脂<span style="color: black;">膳食</span></a></span>，戒烟限酒，<span style="color: black;">瘦身</span>、<span style="color: black;">掌控</span>体重，营养不良<span style="color: black;">病人</span>需额外<span style="color: black;">弥补</span>营养；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 2）适当运动：临床<span style="color: black;">状况</span>改善后，在不<span style="color: black;">导致</span>症状的<span style="color: black;">状况</span>下，进行适当的<span style="color: black;"><a style="color: black;">运动训练</a></span>或规律的体力活动；</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3）严格控水：避免水分摄入<span style="color: black;">太多</span>，加重心脏<span style="color: black;">包袱</span>。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">为何</span>心力衰竭<span style="color: black;">病人</span><span style="color: black;">必要</span>严格<span style="color: black;">掌控</span>水分摄入量？</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当水分进入人体后，部分水会<span style="color: black;">经过</span>血液<span style="color: black;">传送</span>到全身各处。<span style="color: black;">针对</span>心力衰竭<span style="color: black;">病人</span><span style="color: black;">来讲</span>，<span style="color: black;">因为</span><span style="color: black;"><a style="color: black;">心脏泵血功能</a></span>受损，摄入的水分<span style="color: black;">太多</span>，会直接加重心脏的工作负荷，<span style="color: black;">引起</span>心脏功能<span style="color: black;">连续</span>性下降，加速<span style="color: black;">疾患</span><span style="color: black;">发展</span>，<span style="color: black;">乃至</span>诱发<span style="color: black;"><a style="color: black;">急性心力衰竭</a></span>，<span style="color: black;">从而</span><span style="color: black;">引起</span>猝死！</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此呢</span>，心力衰竭病人要<span style="color: black;">尤其</span><span style="color: black;">重视</span>控“水”，<span style="color: black;">包含</span>吃喝进去的水、排出的水。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">尤其</span>是<span style="color: black;"><a style="color: black;">急性期心力衰竭</a></span>病患的水分摄入量应该受到严格<span style="color: black;">掌控</span>，<span style="color: black;">没</span><span style="color: black;">显著</span><span style="color: black;"><a style="color: black;">低血容量</a></span><span style="color: black;">原因</span>的<span style="color: black;">病人</span>，每日饮水、吃饭、<span style="color: black;">果蔬</span>、蔬菜等所有的水分摄入加起来不宜超过1500毫升<a style="color: black;"></a>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">同期</span>，心力衰竭<span style="color: black;">病人</span>还<span style="color: black;">必须</span>借助利尿剂，将水分从<span style="color: black;">身体</span>有效排出，<span style="color: black;">保准</span>出量大于入量，达到“负平衡”，<span style="color: black;">才可</span>减轻心脏功能的工作负荷，改善临床症状。3～5 天后，如<span style="color: black;"><a style="color: black;">肺淤血</a></span>、水肿<span style="color: black;">显著</span>消退，应减少<span style="color: black;"><a style="color: black;">水负平衡量</a></span>，<span style="color: black;">逐步</span>过渡到出入量大体平衡。另<span style="color: black;">运用</span>例<span style="color: black;"><a style="color: black;">利尿剂</a></span>的<span style="color: black;">病人</span><span style="color: black;">必须</span><span style="color: black;">定时</span>复查电解质，避免离子<span style="color: black;">错乱</span><span style="color: black;">出现</span>。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">参考</h2><span style="color: black;">^</span><a style="color: black;">a</a><a style="color: black;">b</a><span style="color: black;">翟琳, 华伟. 心力衰竭器械治疗新<span style="color: black;">发展</span>. 中国实用内科杂志, 2020, 40(3): 200-206.</span><a style="color: black;">^</a><span style="color: black;">中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018.中华心血管病杂志,2018,46(10):760-789.</span>
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我完全同意你的观点，说得太对了。 期待你更多的精彩评论，一起交流学习。 顶楼主，说得太好了！
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