是指病人自觉心中悸动.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,心悸,Palpitation,1,Palpitation,Definition,Palpitation,是指病人自觉心中悸动，惊慌不安，甚则不能自主为主要表现的一种病证。心悸包括惊悸和怔忡两方面，因惊而悸者谓之惊悸，时发时止，病情较轻；若无外因而悸者，谓之怔忡，发作无定时，病情较重。,金匮要略,首提惊悸,济生方,首提怔忡,2,Cause of Disease and,Pathomechanism,Palpitation,的病位在心，其发病与脾、肾、肝、肺四脏功能失调相关。本病为本虚标实，本为气血不足，阴阳亏损；标为气滞，血瘀，痰浊，水饮。,Palpitation,3,Analyses of pathological conditions,心虚胆怯,(,timidity due to heart-deficiency,),心血不足,(,insufficiency of heart blood,),阴虚火旺,(,flaring of fire due to yin-asthenia,),心阳不振,(,inactivation of heart-yang,),水饮凌心,(,fluid retention invading heart,),心血瘀阻,(,stasis of heart blood,),Palpitation,4,Analyses of pathological conditions,Timidity due to heart-deficiency,心悸，善惊易恐，坐卧不安，少寐多梦，舌苔薄白或如常，脉象动数或虚弦。,Insufficiency of heart blood,心悸，头晕，面色不华，倦怠乏力，舌质淡红，脉象细弱。,Palpitation,5,Analyses of pathological conditions,Flaring of fire due to yin-asthenia,心悸不宁，心烦少寐，头晕目眩，手足心热，腰酸耳鸣，舌质红，少苔或无苔，脉象细数。,Inactivation of heart-yang,心悸不安，胸闷气短，面色苍白，形寒肢冷，舌质淡白，脉象虚弱或沉细而数。,Palpitation,6,Analyses of pathological conditions,Fluid retention invading heart,心悸，眩晕，胸脘痞满，形寒肢冷，小便短少；或下肢浮肿，渴不欲饮，恶心吐涎，舌苔白滑，脉弦滑。,Stasis of heart blood,心悸不安，胸闷不舒，心痛时作，或见唇甲青紫，舌质暗或有瘀斑，脉涩或结代。,Palpitation,7,Problems of patients,Palpitation,心输出量减少,恐惧,活动无耐力,睡眠形态紊乱,知识缺乏,潜在并发症,Nursing goals,8,Nursing interventions,Timidity due to heart-deficiency,Principle of nursing,：,镇惊定志，养心安神,Entirety nursing,Life care:,Dietary care:,Drugs care:,Other nursing methods:,Palpitation,9,Nursing interventions,Insufficiency of heart blood,Principle of nursing,：,补血养心，益气安神,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Palpitation,10,Nursing interventions,Flaring of fire due to yin-asthenia,Principle of nursing,：,滋阴请火，养心安神,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Palpitation,11,Nursing interventions,Inactivation of heart-yang,Principle of nursing,：,温补心阳，安神定悸,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Palpitation,12,Nursing interventions,Fluid retention invading heart,Principle of nursing,：,振奋心阳，化气行水,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Palpitation,13,Nursing interventions,Stasis of heart blood,Principle of nursing,：,活血化瘀，理气通结,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Palpitation,14,Nursing evaluation,Introduction on health,积极治疗引起心悸的原发病。,避免诱发心悸的因素，如寒热变化、饮食不节、情志不遂等。,保证充足的休息与睡眠是减轻病情的重要条件。,Palpitation,15,16,胸痹,Chest blockage,17,Chest blockage,Definition,Chest blockage,是以胸部闷痛，甚则胸痛彻背，短气，喘息不得卧为主症的一种疾病。轻者仅感胸闷如窒，呼吸欠畅；重者则有胸痛，严重者胸痛彻背，背痛彻心，手足青冷。,最早的相关论述见与,内经,，,金匮要略,首先正式提出胸痹一名,18,Cause of Disease and,Pathomechanism,Chest blockage,Chest blockage,的主要病机为心脉痹阻；病位以心为主，多与肝、脾、肾三脏功能失调有关，其病理变化主要表现为本虚标实，虚实夹杂。,19,Analyses of pathological conditions,心血痹阻：,stasis of heart blood,痰浊壅塞：,stagnation and obstruction of turbid phlegm,阴寒凝滞：,stagnation of yin-cold,心肾阴虚：,asthenia of cardiac and renal yin,气阴两虚：,asthenia of both,qi,and yin,阳气虚衰：,declination of,yangqi,Chest blockage,20,Analyses of pathological conditions,Stasis of heart blood,胸部刺痛，固定不移，入夜更甚，时或心悸不宁，胸闷气短，舌紫暗，脉沉涩。,Stagnation and obstruction of turbid phlegm,胸闷如窒而痛，或痛引肩背，气短喘促，肢体沉重，形体肥胖，痰多，苔浊腻，脉滑。,Chest blockage,21,Analyses of pathological conditions,Stagnation of yin-cold,胸痛彻背，感寒痛甚，胸闷气短，心悸，重则喘息，不能平卧，面色苍白，四肢厥冷，舌苔白，脉沉细。,Asthenia of cardiac and renal yin,胸闷且痛，心悸盗汗，心烦不寐，腰膝痰软，耳鸣，头晕，舌红或有紫斑，脉细数或细涩。,Chest blockage,22,Analyses of pathological conditions,Asthenia of both,qi,and yin,胸闷隐痛，时作时止，心悸气短，倦怠懒言，面色少华，头晕目眩，遇劳则甚，舌偏红或有齿印，脉细弱无力，或结代。,Declination of,yangqi,胸闷气短，甚则胸痛彻背，心悸，汗出，畏寒肢冷，腰酸乏力，面色苍白，唇甲淡白或青紫，舌淡白或紫暗，脉沉细或沉微欲绝。,Chest blockage,23,Problems of patients,Chest blockage,Nursing goals,胸痛,恐惧,知识缺乏,活动无耐力,24,Nursing interventions,Stasis of heart blood,Principle of nursing,：,活血化瘀，通络止痛,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Chest blockage,25,Nursing interventions,Stagnation and obstruction of turbid phlegm,Principle of nursing,：,通阳泄浊，豁痰开结,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Chest blockage,26,Nursing interventions,Stagnation of yin-cold,Principle of nursing,：,辛温通阳，开痹散结,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Chest blockage,27,Nursing interventions,Asthenia of cardiac and renal yin,Principle of nursing,：,滋阴益肾，养心安神,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Chest blockage,28,Nursing interventions,Asthenia of both,qi,and yin,Principle of nursing,：,益气养阴，活血通络,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Chest blockage,29,Nursing interventions,Declination of,yangqi,Principle of nursing,：,益气通阳，活血通络,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Chest blockage,30,Nursing evaluation,Introduction on health,积极治疗引起胸痹的有关疾病，如高血压，糖尿病等。,坚持适当的体育锻炼，促进心肺功能，使气血调畅，利于康复。,饮食以素食为主，戒除烟酒等不良嗜好，不偏食偏嗜，不暴饮暴食。,参照,内科护理学,相关知识。,Chest blockage,31,眩晕,Dizziness/Vertigo,32,Dizziness/Vertigo,Definition,眩(,blurred vision,),即眼花，晕,(,dizziness,),即头晕，两者常同时并见，故统称为“眩晕”。轻者闭目可止，重者如坐车，旋转不定，不能站立，或伴有恶心、呕吐、汗出、甚则昏倒等症状。,33,Cause of Disease and,Pathomechanism,肝阳上亢,：,hyperactivity of liver-yang,肾精不足：,deficiency of renal essence,气血亏虚：,asthenia of both,qi,and blood,痰浊中阻：,turbid phlegm obstructing in midst,瘀血内阻：,interior retention of blood stasis,Dizziness,多为本虚标实，实为风、火、痰、瘀；虚则气血阴阳之虚。病变脏腑涉及肝、脾、肾，三者之中，又以肝为主。,Dizziness/Vertigo,34,Analyses of pathological conditions,Hyperactivity of liver-yang,Asthenia of both,qi,and blood,Deficiency of renal essence,Turbid phlegm obstructing in midst,瘀血阻络：,blood stasis obstructing collaterals,Dizziness/Vertigo,35,Analyses of pathological conditions,Hyperactivity of liver-yang,眩晕耳鸣，头痛且胀，每因烦劳或恼怒而头晕头痛加剧，面色潮红，急躁易怒，少寐多梦，口苦，舌质红，苔黄，脉弦。,Asthenia of both,qi,and blood,眩晕动则加剧，劳累即发，面色少华或萎黄，唇甲色淡，心悸少寐，神倦懒言，纳呆，舌质淡，脉细弱。,Dizziness/Vertigo,36,Analyses of pathological conditions,Deficiency of renal essence,眩晕，目花，健忘少寐，精神萎靡，腰膝酸软，遗精耳鸣。偏阴虚者，兼见五心烦热，舌质红，脉细数。偏阳虚者，兼见四肢不温，形寒怯冷，舌质淡，脉沉细弱。,Dizziness/Vertigo,37,Analyses of pathological conditions,Turbid phlegm obstructing in midst,眩晕而头重昏蒙，胸脘满闷，纳呆，恶心，体倦多寐，苔白腻，脉濡滑。,Blood stasis obstructing collaterals,眩晕头痛，或健忘，失眠，心悸，精神不振，面或唇色紫暗，舌质有瘀斑瘀点，脉弦涩或细涩。,Dizziness/Vertigo,38,Problems of patients,Nursing goals,Dizziness/Vertigo,39,Nursing interventions,Hyperactivity of liver-yang,Principle of nursing,：,平肝潜阳，滋补肝肾,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Dizziness/Vertigo,40,Nursing interventions,Asthenia of both,qi,and blood,Principle of nursing,：,补益气血，健运脾胃,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Dizziness/Vertigo,41,Nursing interventions,Deficiency of renal essence,Principle of nursing,：,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,偏阴虚者补肾滋阴,偏阳虚者补肾助阳,Dizziness/Vertigo,42,Nursing interventions,Turbid phlegm obstructing in midst,Principle of nursing,：,燥湿祛痰，健脾和胃,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Dizziness/Vertigo,43,Nursing interventions,Blood stasis obstructing collaterals,Principle of nursing,：,祛瘀通络，活血通窍,Entirety nursing,Life care:,Diet care:,Drugs care:,Other nursing methods:,Dizziness/Vertigo,44,Nursing evaluation,Introduction on health,消除各种导致眩晕发生的因素。中年以上之人，积极防治眩晕，预防中风先兆的发生。,避免突然或剧烈的头部运动。眩晕病人康复后不宜高空作业，避免游泳及各种旋转大的动作或游戏，必要时服用乘晕宁等药物预防,积极治疗原发病，如高血压、贫血、脑部病变等。,Dizziness/Vertigo,45,46,