1fy07h 发表于 2024-6-8 00:01:31

警觉！这些症状，可能是心衰的信号丨健康总动员


    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/EhhVKO7Tic1ZfcoEiaHafz2WqIiblU6cJHkDAiahjHibA65ibPXib19AfW7Kw4QAmRh3OtsgOxY375RCTEWmUAvEp3eUw/640?wx_fmt=jpeg&amp;from=appmsg&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1&amp;tp=webp" 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;">2003年的流行病学调查<span style="color: black;">表示</span>，我国35—74岁成人心衰患病率为0.9%。我国人口老龄化加剧，冠心病、高血压、糖尿病、<span style="color: black;">肥壮</span>等慢性病的发病呈<span style="color: black;">提升</span>趋势，医疗水平的<span style="color: black;">加强</span>使心脏<span style="color: black;">疾患</span><span style="color: black;">病人</span><span style="color: black;">存活</span>期延长，<span style="color: black;">引起</span>我国心衰患病率呈<span style="color: black;">连续</span><span style="color: black;">上升</span>趋势。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">本期嘉宾</span></strong></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_jpg/EhhVKO7Tic1ZSNA4IKV13nwbJgXoQH7YtgM67lqu9QBwPZkibcbutxbPS1iahCL3XUGrFQV1Giaiavn7z1AU6D7v6qg/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></p><strong style="color: blue;">上海市闵行区中西医结合医院</strong>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">心内科行政<span style="color: black;">专家</span></strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">国医大师沈宝藩传承工作室负责人</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">任炜炜</strong></span></p><strong style="color: blue;">（点击收听完整音频）</strong><img src="https://mmbiz.qpic.cn/mmbiz_gif/EhhVKO7Tic1Y06niaGRKDfxcAhzTPCTzYUtJ8MtfcLHWZXJ09sc6MO8Wm3JBctA4gj6cgjLJwIagdojnPHtib1WYw/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">心衰有<span style="color: black;">那些</span><span style="color: black;">害处</span>？</span></strong></span><span style="color: black;">临床上<span style="color: black;">大概</span>一半的心衰<span style="color: black;">病人</span>，在诊断出心衰的时候就<span style="color: black;">已然</span>是终末期心衰，而一旦发展为终末期心衰，五年内死亡率接近70%。随着医疗水平的<span style="color: black;">持续</span>发展，心力衰竭<span style="color: black;">病人</span>，只要做到</span><strong style="color: blue;"><span style="color: black;">早<span style="color: black;">发掘</span>、早治疗</span></strong><span style="color: black;">，就有可能把<span style="color: black;">损伤</span>降到最低。</span><strong style="color: blue;"><span style="color: black;">心衰会影响全身脏器的功能</span></strong><span style="color: black;">：肾血管灌注不足可致肾功能<span style="color: black;">反常</span>，肝脏长期<span style="color: black;">处在</span>淤血缺氧的状态可致心原性肝硬化，肺部淤血可<span style="color: black;">增多</span><span style="color: black;">呼气</span>道感染概率，<span style="color: black;">长时间</span>卧床的<span style="color: black;">病人</span>下肢静脉易形成血栓。心衰的种种症状严重限制了<span style="color: black;">病人</span>的<span style="color: black;">平常</span>活动，影响生活质量。心衰还会影响<span style="color: black;">病人</span>的工作、社交，<span style="color: black;">乃至</span>带来</span><strong style="color: blue;"><span style="color: black;">抑郁、焦虑</span></strong><span style="color: black;">等<span style="color: black;">消极</span><span style="color: black;">心情</span>。</span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/EhhVKO7Tic1ZSNA4IKV13nwbJgXoQH7YteFW77BdfObia2piaTTicCaibXb7x1HVLqtPmUdnwHOUV7p5BrEFjjZsPWA/640?wx_fmt=png&amp;from=appmsg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></p><img src="https://mmbiz.qpic.cn/mmbiz_gif/EhhVKO7Tic1Y06niaGRKDfxcAhzTPCTzYUtJ8MtfcLHWZXJ09sc6MO8Wm3JBctA4gj6cgjLJwIagdojnPHtib1WYw/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">心衰会有<span style="color: black;">那些</span>症状？</span></strong></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">心衰<span style="color: black;">重点</span>表现为</span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">呼气</span>困难</strong></span><span style="color: black;">、</span><strong style="color: blue;"><span style="color: black;">疲乏</span></strong><span style="color: black;">和</span><strong style="color: blue;"><span style="color: black;">液体潴留</span></strong><span style="color: black;">（肺淤血、体循环淤血及外周水肿）。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">呼气</span>困难是左心衰竭最早和最<span style="color: black;">平常</span>的症状。</span></strong><span style="color: black;">病情较轻的<span style="color: black;">病人</span>仅仅于较重的体力劳动时<span style="color: black;">出现</span><span style="color: black;">呼气</span>困难，<span style="color: black;">休憩</span>后<span style="color: black;">火速</span>消失。随病情<span style="color: black;">发展</span>，<span style="color: black;">逐步</span><span style="color: black;">显现</span>轻度体力活动即感到<span style="color: black;">呼气</span>困难，严重者在<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;">导致</span>被迫采取半卧位或坐位<span style="color: black;">休憩</span>。</span><strong style="color: blue;"><span style="color: black;">阵发性夜间<span style="color: black;">呼气</span>困难</span></strong><span style="color: black;">是左心衰竭的另一种表现，<span style="color: black;">病人</span>常在熟睡中憋醒，有窒息感，被迫坐起。病情轻的<span style="color: black;">病人</span>坐起后几分钟症状消失，严重的<span style="color: black;">病人</span>可<span style="color: black;">连续</span>不缓解，<span style="color: black;">乃至</span><span style="color: black;">显现</span><span style="color: black;">呼气</span>窘迫和口唇紫绀。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">心衰<span style="color: black;">病人</span>经常并且<span style="color: black;">初期</span>就<span style="color: black;">能够</span><span style="color: black;">显现</span></span><strong style="color: blue;"><span style="color: black;">疲乏<span style="color: black;">没</span>力</span></strong><span style="color: black;">，运动能力下降等症状。心衰<span style="color: black;">导致</span>的</span><strong style="color: blue;"><span style="color: black;">水肿</span></strong><span style="color: black;">多先见于身体低垂的部位，<span style="color: black;">例如</span>下肢，卧床<span style="color: black;">病人</span>常表<span style="color: black;">此刻</span>腰、背及尾椎骨<span style="color: black;">周边</span>等部位，按压可<span style="color: black;">显现</span>凹陷，严重的<span style="color: black;">病人</span>可<span style="color: black;">显现</span>全身水肿。下肢水肿多于傍晚<span style="color: black;">显现</span>或加重，<span style="color: black;">休憩</span><span style="color: black;">一晚上</span>后可减轻或消失。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">部分<span style="color: black;">病人</span>还会<span style="color: black;">显现</span></span><strong style="color: blue;"><span style="color: black;">胸腹腔积液</span></strong><span style="color: black;">。心衰<span style="color: black;">病人</span>常常<span style="color: black;">显现</span>咳嗽、咳白色黏痰或<span style="color: black;">泡泡</span>痰，严重者可表现为咳粉红色<span style="color: black;">泡泡</span>痰或血痰，多与<span style="color: black;">呼气</span>困难并存。心衰<span style="color: black;">病人</span>还可有</span><strong style="color: blue;"><span style="color: black;">食欲不振、腹胀、肝区痛、失眠、心慌</span></strong><span style="color: black;">等不特异的症状。严重心衰<span style="color: black;">导致</span>脑缺氧时，<span style="color: black;">病人</span>还可<span style="color: black;">显现</span>嗜睡、眩晕、眼前发黑、<span style="color: black;">认识</span>丧失、抽搐等症状。</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_png/EhhVKO7Tic1ZSNA4IKV13nwbJgXoQH7YtdhJAlkcNHhQ4bo7AHj6tdWCicfY0SOdHpBewtS9QH7n1dRYQ4eV25Pg/640?wx_fmt=png&amp;from=appmsg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></p><img src="https://mmbiz.qpic.cn/mmbiz_gif/EhhVKO7Tic1Y06niaGRKDfxcAhzTPCTzYUtJ8MtfcLHWZXJ09sc6MO8Wm3JBctA4gj6cgjLJwIagdojnPHtib1WYw/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">临床上怎么<span style="color: black;">评定</span>心衰？</span></strong></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">心力衰竭是一个</span><strong style="color: blue;"><span style="color: black;">逐步<span style="color: black;">发展</span>，<span style="color: black;">逐步</span>加重</span></strong><span style="color: black;">的<span style="color: black;">疾患</span>，临床<span style="color: black;">通常</span>可分为</span><strong style="color: blue;"><span style="color: black;">四个<span style="color: black;">周期</span></span></strong><span style="color: black;">：</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">前心衰<span style="color: black;">周期</span></span></strong></span><span style="color: black;">：<span style="color: black;">病人</span>存在心衰高危<span style="color: black;">原因</span>，但尚<span style="color: black;">没</span>心脏结构或功能<span style="color: black;">反常</span>，<span style="color: black;">亦</span><span style="color: black;">无</span>心衰的症状和体征；</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">前临床心衰<span style="color: black;">周期</span></span></strong><span style="color: black;">：<span style="color: black;">病人</span><span style="color: black;">没</span>心衰的症状和体征，但已有心脏结构改变，如左心室肥厚等；</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">临床心衰<span style="color: black;">周期</span></span></strong><span style="color: black;">：<span style="color: black;">病人</span>有<span style="color: black;">基本</span>结构性心脏病，<span style="color: black;">亦</span>有心衰的症状和体征；</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">难治性终末期心衰<span style="color: black;">周期</span></span></strong><span style="color: black;">：<span style="color: black;">病人</span><span style="color: black;">休憩</span>时仍有症状，须<span style="color: black;">长时间</span>治疗。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">还有一个更实用的分级<span style="color: black;">办法</span>，叫做</span><strong style="color: blue;"><span style="color: black;">纽约心功能分级</span></strong><span style="color: black;">。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">Ⅰ级：病人<span style="color: black;">身患</span>心脏病，但平时<span style="color: black;">通常</span>活动不<span style="color: black;">导致</span>疲乏、心悸、<span style="color: black;">呼气</span>困难、心绞痛等症状；</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">Ⅱ级：体力活动轻度受限。<span style="color: black;">休憩</span>时<span style="color: black;">没</span>自觉症状，但平时<span style="color: black;">通常</span>活动可<span style="color: black;">显现</span><span style="color: black;">以上</span>症状，<span style="color: black;">休憩</span>后<span style="color: black;">火速</span>缓解；</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">Ⅲ级：体力活动<span style="color: black;">显著</span>受限。<span style="color: black;">休憩</span>时<span style="color: black;">没</span>症状，<span style="color: black;">小于</span>平时<span style="color: black;">通常</span>活动量<span style="color: black;">就可</span><span style="color: black;">显现</span><span style="color: black;">以上</span>症状，<span style="color: black;">休憩</span>较<span style="color: black;">长期</span>后缓解；</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">Ⅳ级：<span style="color: black;">不可</span>从事任何体力活动。<span style="color: black;">休憩</span>时<span style="color: black;">亦</span>有心衰的症状，体力活动后加重。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">最方便的<span style="color: black;">评定</span><span style="color: black;">办法</span>，当属</span><span style="color: black;"><strong style="color: blue;">6分钟步行实验</strong></span><span style="color: black;">。<span style="color: black;">病人</span>在平地尽快行走，测定6分钟的步行距离。重度心衰：6分钟步行距离＜150米；中度心衰：6分钟步行距离150米—450米；轻度心衰：6分钟步行距离＞450米。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">专科提示：<span style="color: black;">针对</span>有心衰危险<span style="color: black;">原因</span>（高血压，糖尿病，冠心病，心肌病等）及症状的<span style="color: black;">病人</span><span style="color: black;">意见</span>心内科门诊</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">定时</span>监测心电图，心脏彩超，<span style="color: black;">评定</span>心衰指标pro-BNP/BNP等<span style="color: black;">关联</span>生化<span style="color: black;">检测</span></span></strong><span style="color: black;">，早<span style="color: black;">发掘</span>早预防。</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_png/EhhVKO7Tic1ZSNA4IKV13nwbJgXoQH7YtanY4VXqUHXfBxwCz4GF0O0QeckjRH0p8c9DDHaia89yEzOwMurDFZug/640?wx_fmt=png&amp;from=appmsg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></p><img src="https://mmbiz.qpic.cn/mmbiz_gif/EhhVKO7Tic1Y06niaGRKDfxcAhzTPCTzYUtJ8MtfcLHWZXJ09sc6MO8Wm3JBctA4gj6cgjLJwIagdojnPHtib1WYw/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">心衰<span style="color: black;">平常</span>的病因有<span style="color: black;">那些</span>？</span></strong></span></strong></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">原发性心肌损害和<span style="color: black;">反常</span></span></strong><span style="color: black;">是<span style="color: black;">导致</span>心衰最<span style="color: black;">重点</span>的病因。其中，扩张型心肌病（DCM）是一种<span style="color: black;">原由</span>未明的原发性心肌<span style="color: black;">疾患</span>，其<span style="color: black;">重点</span>特征为心室扩大，是心衰的<span style="color: black;">平常</span>病因。</span></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;">另外</span>，<span style="color: black;">各样</span></span><strong style="color: blue;"><span style="color: black;">心血管<span style="color: black;">疾患</span></span></strong><span style="color: black;">，如高血压、冠心病、左心室肥厚、心肌梗死、心脏瓣膜病、<span style="color: black;">心率</span>失常等，若不给予<span style="color: black;">即时</span>科学诊治，病情<span style="color: black;">发展</span>恶化<span style="color: black;">亦</span>可<span style="color: black;">引起</span>心衰。除心血管<span style="color: black;">疾患</span>外，非心血管<span style="color: black;">疾患</span><span style="color: black;">亦</span>可<span style="color: black;">引起</span>心衰，</span><strong style="color: blue;"><span style="color: black;">糖尿病、<span style="color: black;">肥壮</span>、代谢综合症、甲亢等</span></strong><span style="color: black;"><span style="color: black;">亦</span>是心衰的<span style="color: black;">平常</span>病因。这些<span style="color: black;">病人</span>为心力衰竭的高危人群，除治疗原有<span style="color: black;">疾患</span>外，应<span style="color: black;">定时</span>做心电图、心脏彩超等<span style="color: black;">检测</span>，若<span style="color: black;">显现</span>心衰的症状<span style="color: black;">即时</span>就诊。<span style="color: black;">另外</span>，<span style="color: black;">有些</span></span><strong style="color: blue;"><span style="color: black;">治疗肿瘤<span style="color: black;">药品</span>、抗抑郁药、非甾体类抗炎药等</span></strong><span style="color: black;"><span style="color: black;">亦</span>可<span style="color: black;">引起</span>或加重心衰。<span style="color: black;">因此呢</span>，<span style="color: black;">意见</span>肿瘤<span style="color: black;">病人</span>抗肿瘤治疗前系统<span style="color: black;">评定</span>心脏功能，并在治疗过程中动态监测。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">其他</span><strong style="color: blue;"><span style="color: black;">系统性<span style="color: black;">疾患</span></span></strong><span style="color: black;"><span style="color: black;">亦</span>可<span style="color: black;">导致</span>心衰，例如多发性骨髓瘤、浆细胞病可<span style="color: black;">引起</span>心脏淀粉样变。心脏淀粉样变病死率高、预后差，应尽早诊治。除<span style="color: black;">疾患</span>外，</span><strong style="color: blue;"><span style="color: black;">酗酒<span style="color: black;">亦</span>可<span style="color: black;">引起</span>心衰</span></strong><span style="color: black;">。酒精性心肌病的发病与</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">长时间</span><span style="color: black;">海量</span>的酒精摄入</span></strong><span style="color: black;">有密切关系，多<span style="color: black;">出现</span>于30—55岁的男性。有10年以上<span style="color: black;">海量</span>饮酒史、<span style="color: black;">显现</span>心脏病的症状和体征、能排除其他心脏病的<span style="color: black;">病人</span>应<span style="color: black;">思虑</span>本病。基于以上病因，<span style="color: black;">意见</span>积极<span style="color: black;">掌控</span>血压、血糖、血脂水平，<span style="color: black;">掌控</span>体重，戒烟限酒以预防或延缓心衰的<span style="color: black;">出现</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_jpg/EhhVKO7Tic1ZSNA4IKV13nwbJgXoQH7Ytojan1f6ich4EFo6ZLzricxKP41pJvTA1ibD6gJg23RJLDr8faqICyDmOg/640?wx_fmt=jpeg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></p><img src="https://mmbiz.qpic.cn/mmbiz_gif/EhhVKO7Tic1Y06niaGRKDfxcAhzTPCTzYUtJ8MtfcLHWZXJ09sc6MO8Wm3JBctA4gj6cgjLJwIagdojnPHtib1WYw/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">心衰<span style="color: black;">病人</span>用药过程中，</span></strong></span></strong></span></strong><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">有<span style="color: black;">那些</span><span style="color: black;">必须</span><span style="color: black;">重视</span>的方面？</span></strong></span></strong></span></strong>
    <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;">病人</span><span style="color: black;">必须</span><span style="color: black;">长时间</span>依靠<span style="color: black;">药品</span><span style="color: black;">掌控</span>，按医嘱<span style="color: black;">长时间</span>服药能够有效减轻症状，如心慌、胸闷、<span style="color: black;">呼气</span>困难、疲乏<span style="color: black;">没</span>力，消除水肿，从而改善心脏功能，<span style="color: black;">小心</span>脏功能改善后，<span style="color: black;">存活</span>质量将得以<span style="color: black;">加强</span>。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">用药过程中，需熟悉所用<span style="color: black;">药品</span>的名<span style="color: black;">叫作</span>、剂量、时间、<span style="color: black;">办法</span>、可能<span style="color: black;">显现</span>的不良反应及预防方式：</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1.治疗心衰的<span style="color: black;">药品</span>，<span style="color: black;">常常</span>会影响血压，<span style="color: black;">因此呢</span>用药<span style="color: black;">时期</span>应</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">按时</span><span style="color: black;">测绘</span>血压</span></strong><span style="color: black;">，并作记录。变动体位时动作要缓慢，<span style="color: black;">以避免</span><span style="color: black;">显现</span><span style="color: black;">头昏</span>、眼花、<span style="color: black;">乃至</span><span style="color: black;">昏倒</span>。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2.<span style="color: black;">吃下</span>利尿剂时，常需</span><strong style="color: blue;"><span style="color: black;">间歇<span style="color: black;">运用</span></span></strong><span style="color: black;">，并<span style="color: black;">按照</span>病情<span style="color: black;">调节</span>剂量，<span style="color: black;">病人</span>应观察<span style="color: black;">近期</span>有<span style="color: black;">没</span>疲乏、食欲不振、恶心、呕吐等症状，<span style="color: black;">每日</span>应多食<span style="color: black;">有些</span><span style="color: black;">饱含</span></span><strong style="color: blue;"><span style="color: black;">钾</span></strong><span style="color: black;">的<span style="color: black;">食品</span>，如鲜橙汁、西红柿汁、香蕉、枣、杏、<span style="color: black;">没</span>花果、葡萄干、梅干、马铃薯、菠菜、花菜等，<span style="color: black;">吃下</span>利尿剂的时间宜在早晨或日间，不要太晚，<span style="color: black;">以避免</span>多次小便而影响<span style="color: black;">睡觉</span>，并</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">每日</span>同一时间<span style="color: black;">测绘</span>体重</span></strong><span style="color: black;">，以监测体重减轻的程度，并作记录，等下次复诊时<span style="color: black;">供给</span>给<span style="color: black;">大夫</span>做<span style="color: black;">评定</span>药效的参考。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3.<span style="color: black;">吃下</span>时β受体阻滞剂，务必按医嘱按时、按量<span style="color: black;">吃下</span>，</span><strong style="color: blue;"><span style="color: black;">切勿随意停药</span></strong><span style="color: black;">，学会</span><strong style="color: blue;"><span style="color: black;">自测脉搏</span></strong><span style="color: black;">，当脉搏每分钟在55次以下要<span style="color: black;">即时</span><span style="color: black;">看病</span>，<span style="color: black;">定时</span>随访，<span style="color: black;">调节</span>用药<span style="color: black;">方法</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_png/EhhVKO7Tic1ZSNA4IKV13nwbJgXoQH7YtGYrozYb5DBwaaffIMWrTdRTzWFiacG2xSzvgtbp4ElpjNI8PkjFQWKw/640?wx_fmt=png&amp;from=appmsg&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></p><img src="https://mmbiz.qpic.cn/mmbiz_gif/EhhVKO7Tic1Y06niaGRKDfxcAhzTPCTzYUtJ8MtfcLHWZXJ09sc6MO8Wm3JBctA4gj6cgjLJwIagdojnPHtib1WYw/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">心衰<span style="color: black;">病人</span><span style="color: black;">平常</span>生活中，</span></strong></span></strong></span></strong><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">有<span style="color: black;">那些</span><span style="color: black;">必须</span><span style="color: black;">重视</span>的方面？</span></strong></span></strong></span></strong>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">第1</span>，<span style="color: black;">病人</span>要改变生活方式，</span><strong style="color: blue;"><span style="color: black;">戒除不良<span style="color: black;">爱好</span></span></strong><span style="color: black;">，<span style="color: black;">包含</span>吸烟、饮酒、<span style="color: black;">药品</span>依赖等。要</span><strong style="color: blue;"><span style="color: black;">尽快就诊</span></strong><span style="color: black;">于心衰专科，由专科<span style="color: black;">大夫</span>开具治疗症状及改善预后的<span style="color: black;">药品</span>。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">第二，<span style="color: black;">必须</span></span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">定时</span>回到门诊随访</span></strong><span style="color: black;">，向<span style="color: black;">大夫</span><span style="color: black;">描述</span>近期的自我感觉变化。由<span style="color: black;">大夫</span><span style="color: black;">按照</span><span style="color: black;">病人</span>近期<span style="color: black;">情况</span>进行个体化<span style="color: black;">调节</span>。<span style="color: black;">通常</span>性随访每1<span style="color: black;">—</span>2个月1次。重点随访每3<span style="color: black;">—</span>6个月1次。<span style="color: black;">病人</span><span style="color: black;">自己</span><span style="color: black;">疾患</span><span style="color: black;">情况</span>变化，如感冒、腹泻、血糖<span style="color: black;">上升</span>等等都<span style="color: black;">必须</span>给予相应治疗。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">第三，严重心衰<span style="color: black;">病人</span></span><strong style="color: blue;"><span style="color: black;">摄入液体量限制在<span style="color: black;">每日</span>1.5<strong style="color: blue;"><span style="color: black;">—</span></strong>2.0升</span></strong><span style="color: black;">，有助于减轻症状并缓解肺淤血。<span style="color: black;">这儿</span>要<span style="color: black;">重视</span>的是，液体摄入量<span style="color: black;">包含</span>来自输液、饮水、汤、粥、蔬菜、水果中的水分，并非仅是饮水量。</span><strong style="color: blue;"><span style="color: black;">每日测定体重</span></strong><span style="color: black;">以便<span style="color: black;">初期</span><span style="color: black;">发掘</span>液体潴留非常<span style="color: black;">要紧</span>。<span style="color: black;">短期</span>内体重<span style="color: black;">增多</span>是身<span style="color: black;">身体</span>液体潴留的“信号”。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">第四，心衰加重期<span style="color: black;">病人</span>应该</span><strong style="color: blue;"><span style="color: black;">卧床<span style="color: black;">休憩</span></span></strong><span style="color: black;">，可在床上做下肢被动运动以预防下肢深部静脉血栓形成。临床<span style="color: black;">状况</span>改善后，在不<span style="color: black;">导致</span>不适的<span style="color: black;">状况</span>下，鼓励<span style="color: black;">病人</span></span><strong style="color: blue;"><span style="color: black;">适度活动</span></strong><span style="color: black;">，以防止肌肉废用性萎缩。可参与<span style="color: black;">有些</span>心脏能够承受的、力所能及的活动，但切勿操之过急，<span style="color: black;">重视</span></span><strong style="color: blue;"><span style="color: black;">循序渐进</span></strong><span style="color: black;">。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">第五，心衰<span style="color: black;">病人</span>还要避免以下<span style="color: black;">状况</span>：过度<span style="color: black;">疲劳</span>和体力活动；<span style="color: black;">心情</span>激动和精神紧张；感冒、<span style="color: black;">呼气</span>道及其他<span style="color: black;">各样</span>感染；<span style="color: black;">膳食</span><span style="color: black;">欠妥</span>，未<span style="color: black;">掌控</span>水量，<span style="color: black;">食品</span>偏咸；不遵从医嘱，擅自停药、<span style="color: black;">减少</span>；未经专科<span style="color: black;">大夫</span>同意擅自加用其他<span style="color: black;">药品</span>。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p><img src="https://mmbiz.qpic.cn/mmbiz_gif/EhhVKO7Tic1Y06niaGRKDfxcAhzTPCTzYUtJ8MtfcLHWZXJ09sc6MO8Wm3JBctA4gj6cgjLJwIagdojnPHtib1WYw/640?wx_fmt=gif&amp;tp=webp&amp;wxfrom=5&amp;wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">心衰<span style="color: black;">病人</span><span style="color: black;">怎样</span>进行运动<span style="color: black;">恢复</span>治疗？</span></strong></span></strong></span></strong></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">运动<span style="color: black;">恢复</span><span style="color: black;">指的是</span><span style="color: black;">经过</span>运动方式对心脏进行<span style="color: black;">恢复</span><span style="color: black;">熬炼</span>，<span style="color: black;">重点</span>运动方式为有氧运动，<span style="color: black;">包含</span>走路、慢跑、踏车、打太极拳、坐式八段锦等。慢性心衰<span style="color: black;">病人</span>心肺功能较差，</span><strong style="color: blue;"><span style="color: black;">不适宜<span style="color: black;">很强</span>强度的运动</span></strong><span style="color: black;">。</span></p><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">记者：魏天浩</span><span style="color: black;">
      <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">编辑：岳顺顺（实习）</p>
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情迷布拉格 发表于 2024-9-6 04:34:45

楼主继续加油啊！外链论坛加油！

4lqedz 发表于 2024-9-26 08:53:40

“沙发”（SF，第一个回帖的人）‌

nqkk58 发表于 2024-10-29 04:33:06

一看到楼主的气势，我就觉得楼主同在社区里灌水。

1fy07h 发表于 2024-11-9 10:41:56

期待更新、坐等、迫不及待等。

4zhvml8 发表于 6 天前

“NB”（牛×的缩写，表示叹为观止）‌
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