心力衰竭的疑难病例讨论课件

This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.慢性心力衰竭的护理慢性心力衰竭的护理疑难护理病例讨论崂山急诊内科2016.7慢性心力衰竭的护理疑难护理病例讨论1This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心衰概述慢性心衰的总发病率0.5-2%，发达国家达10%慢性心衰是大多数心血管疾病的最终归宿，也是最重要的死亡原因半数4年内死亡，重症患者半数1年内死亡心衰概述慢性心衰的总发病率0.5-2%，发达国家达10%2This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报一般情况：张某，女性，81岁主诉：胸闷憋气5天现病史：于5天前无明显诱因出现胸闷、憋气，伴乏力，咳嗽，咳痰困难，伴双手、双下肢水肿，自行吸氧未好转，2天前憋气加重，不能平卧，以“心力衰竭”于2016.5.23收入院既往史：冠心病 高血压 糖尿病 脑梗死 下肢深静脉血栓形成 肺栓塞主要诊断：心力衰竭 病例汇报一般情况：张某，女性，81岁3This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报查体：患者神志清，双肺呼吸音粗，可闻及干湿性啰音，心率85次/分，律齐，血压154/93mmHg，双下肢水肿病例汇报查体：患者神志清，双肺呼吸音粗，可闻及干湿性啰音，心4This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.辅助检查D二聚体2600ng/ml肌红蛋白347ng/mlB型脑利尿钠肽3030pg/ml尿素氮12.10mmol/L肌酐144.96umol/L辅助检查D二聚体2600ng/ml5This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.辅助检查胸部CT:右肺多条片影，考虑炎症可能性大，双侧少量胸腔积液可能性大，心影增大超声心动图：心肌梗死后改变，左室舒张与收缩功能减低，肺动脉高压下肢B超：右侧股浅动脉闭塞，左下肢皮下水肿辅助检查胸部CT:右肺多条片影，考虑炎症可能性大，双侧少量胸6This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.治疗入院后给予呋塞米利尿，爱倍扩血管，地高辛强心，凯韦可抗感染，枢维新平喘，科素亚降血压，糖适平降糖治疗入院后给予呋塞米利尿，爱倍扩血管，地高辛强心，凯韦可抗感7This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心力衰竭的疑难病例讨论课件8This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心力衰竭的疑难病例讨论课件9This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.讨论主题1.下肢深静脉血栓的护理2.心衰病人的液体及电解质管理3.癫痫发作的护理4.皮肤粘膜的护理讨论主题1.下肢深静脉血栓的护理10This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.下肢深静脉血栓(DVT)崂山普外科下肢深静脉血栓(DVT)崂山普外科11This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.定义下肢静脉血栓形成是指血液在下肢静脉内不正常凝结，堵塞管腔，导致静脉回流障碍的一种疾病。定义下肢静脉血栓形成是指血液在下肢静脉内不正常凝结，堵塞管腔12This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.DVT病因静脉内膜损伤：静脉内膜损伤：静脉内注射刺激性药物和高渗溶液；静脉局部挫伤、撕裂伤或骨折碎片损伤；骨颈骨折损伤股总静脉，骨盆骨折和盆腔手术血流缓慢血流缓慢：血流缓慢是造成下肢深静脉血栓形成的首要因素（卧床或者麻醉后缺乏下肢肌对静脉的挤压作用）血液高凝状态血液高凝状态：各种大型手术是引起血液高凝状态的常见原因。（脾切除术后血小板增加；烧伤或者严重脱水增加血液凝固性；癌细胞释放的物质增加血液凝固性；避孕药、止血药、脱水剂的使用增加血液凝固性）DVT病因静脉内膜损伤：静脉内注射刺激性药物和高渗溶液；静脉13This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高危人群高危人群如果没有预防措施,患小腿DVT的机会为40%80%髋部骨折及术后下肢骨折及术后尤其是术中应用止血带的原发下肢血管疾病高龄、女性、吸烟、糖尿病、肥胖心功能不全和以往有DVT形成史高危人群高危人群如果没有预防措施,患小腿DVT的机会为40%14This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.临 床 表 现疼痛疼痛：最早出现的症状肿胀肿胀：最常见的症状：下肢肿胀是最主要的或者是唯一的症状，大多数为单侧下肢肿胀。膝关节以下肿胀提示血栓累及腘或股浅静脉整个下肢肿胀表明髂-股静脉血栓形成浅静脉曲张（后遗症）浅静脉曲张（后遗症）：深静脉血栓形成后的继发反应临 床 表 现疼痛：最15This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.检查血浆D二聚体测定彩色多普勒超声探查静脉造影：是DVT诊断的“金标准”放射性核素血管扫描检查 螺旋CT静脉造影检查血浆D二聚体测定16This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.分型周围型周围型中央型中央型混合型混合型分型周围型中央型混合型17This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.周围型周围型18This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.中央型中央型19This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.混合型混合型20This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.股白肿股白肿21This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.股青肿股青肿22This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.DVT并发症肺栓塞出血DVT并发症肺栓塞23This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.肺栓塞肺栓塞24This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.肺栓塞的临床表现肺栓塞的临床表现25This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.急性肺栓塞的急救处理立即平卧避免做深呼吸咳嗽剧烈翻动报告医生同时高流量吸氧建立静脉通道心电监护配合医生抢救急性呼吸窘迫者行气管插管或机械通气心跳骤停者心肺复苏术急性肺栓塞的急救处理立即避免报告医生同时配合急性呼吸窘迫者行26This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.现代护理的发展方向防治结合预防在先预防在先加强评估加强评估及时处理及时处理 现代护理的发展方向防治结合预防在先加强评估及时处27This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.基本预防抬高患肢，禁止腘窝及小腿下单独垫枕；加强观察避免下肢静脉穿刺，特别是反复穿刺、尤其是左侧避免脱水戒烟戒酒 控制血糖血脂多作深呼吸及咳嗽动作手术操作轻巧 避免静脉内膜损伤规范下肢止血带的应用鼓励患者主动活动 尽早下床基本预防抬高患肢，禁止腘窝及小腿下单独垫枕；加强观察28This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.物理预防遵医嘱应用：遵医嘱应用：足底静脉泵足底静脉泵间歇充间歇充气加压装置气加压装置梯度压力弹力袜梯度压力弹力袜下列情况禁用下列情况禁用：充血性心力衰竭，肺水肿和下肢严重水肿充血性心力衰竭，肺水肿和下肢严重水肿下肢深静脉血栓症，血栓性静脉炎或肺栓塞下肢深静脉血栓症，血栓性静脉炎或肺栓塞下肢局部情况异常下肢局部情况异常(皮炎皮炎,坏疽坏疽,近期接受皮肤移植术近期接受皮肤移植术),下下肢血管严重硬化或其他缺血性血管病及下肢严重畸形等肢血管严重硬化或其他缺血性血管病及下肢严重畸形等 物理预防遵医嘱应用：足底静脉泵间歇充气加压装置梯度压力29This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.物理预防方法梯度压力弹力袜梯度压力弹力袜（GCS）间歇充气加压装置间歇充气加压装置（IPC）足底静脉泵足底静脉泵（VFP）物理预防方法梯度压力弹力袜间歇充气加压装置足底静脉泵30This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.药物预防遵医嘱正确应用：遵医嘱正确应用：低分子肝素钙等药物、普通肝素低分子肝素钙等药物、普通肝素UFH慎用止血药慎用止血药药物预防遵医嘱正确应用：31This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.DVT护理措施绝对卧床休息1014d，抬高患肢2030、制动，禁止按摩、热敷、理疗及做剧烈运动，避免用力排便，以免造成栓子脱落，并发肺栓塞每班观察下肢肿胀程度及皮肤温度、色泽及足背动脉搏动，每日测量并记录患肢不同平面的周径并记录，以判断疗效DVT护理措施绝对卧床休息1014d，抬高患肢203032This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.溶栓护理 DVT护理措施并发症观察：严密观察有无牙龈出血、鼻衄、注射部位及消化道出血倾向。要特别注意有无头痛、呕吐、意识障碍、肢体瘫痪麻木等颅内出血迹象，如有出血倾向及时报告医生、护士。同时监测凝血酶原时间、出凝血时间为了保证疗效，溶栓药物现配现用，遵医嘱或按要求滴注观察有无胸痛、呼吸困难、咳嗽、出汗、咯血、休克、晕厥等肺栓塞症状。对突然发生的呼吸困难、紫绀、高度提示肺栓塞（PE）溶栓护理 DVT护理措施并发症观察：严密观察有无牙龈出血33This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.DVT治疗新进展导管溶栓治疗腔静脉滤器联合溶栓治疗DVT治疗新进展导管溶栓治疗34This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心衰患者的液体及电解质管理心衰患者的液体及电解质管理崂山重症监护室心衰患者的液体及电解质管理崂山重症监护室35This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心衰的症状心衰的症状左心衰：肺循环淤血、心排血量降低：进行性劳力性呼吸困难夜间阵发性呼吸困难端坐呼吸急性肺水肿右心衰：体循坏淤血，腹部纳差，恶心呕吐，颈静脉充盈，肝颈静脉回流症阳性，肝脏肿大，水肿，胸水，腹水，紫绀心衰的症状左心衰：肺循环淤血、心排血量降低：进行性劳力性呼吸36This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.液体潴留的评估液体潴留的评估症状：劳力性呼吸困难，端坐呼吸，夜间阵发性呼吸困难，心慌心悸，尿量减少，腹胀查体：体重增加（短时间内体重增加是液体潴留的可靠指标），颈静脉怒张（容量超载最可靠的体征），双下肢或全身水肿，胸水、腹水。辅助检查：肺部罗音，胸片提示肺淤血、肺水肿，心界扩大，BNP升高液体潴留的评估症状：劳力性呼吸困难，端坐呼吸，夜间阵发性呼吸37This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.准确记录出入量准确记录出入量正常成人每日水的出入平衡量来源量（来源量（ml）摄入量（摄入量（ml）排除器官排除器官排出量（排出量（ml）饮水或饮料1200肾脏（尿）1500食物1000肺（呼吸）500内生水300皮肤（蒸发）350大肠（粪便）150合计2500合计2500准确记录出入量正常成人每日水的出入平衡量来源量（ml）摄入量38This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.监测体重监测体重每日测定体重以及早发现液体潴留如在3天内体重突然增加2kg以上考虑患者已有钠、水潴留，需要加大利尿剂剂量监测体重每日测定体重以及早发现液体潴留39This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.限钠限水限钠限水心衰患者的潴钠能力很强，应严格限制钠的摄入避免含钠较高的食物钠盐摄入：轻度心衰23g/d 中重度心衰2g/d严重低钠血症（血钠130mmol/L)者，液体摄入量应7mmol/L),立即行CRRT治疗高钾血症停用保钾利尿剂，纠正酸中毒47This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心衰液体管理注意事项心衰液体管理注意事项滴速：严格控制输液速度，心脏病人2030gtt/min，严重心衰病人：成人20gtt/min,婴儿10gtt/min密切监测尿量、体重、血钾等电解质负平衡的管理：应用强效排钠利尿剂时不要过度控制钠盐的摄入，否则可导致低钠血症监测体重：早餐前、穿相同衣服、排空二便，通常使体重每日下降0.51kg左右心衰液体管理注意事项滴速：严格控制输液速度，心脏病人20348This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心衰液体管理注意事项心衰液体管理注意事项难治性心衰患者严格控制液体入量：24h总入量宜控制在1500m.24h补液量宜控制在补液量+800ml每日出入量应依据床旁胸片所示肺水肿程度而定心衰液体管理注意事项难治性心衰患者严格控制液体入量：24h总49This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心衰液体管理注意事项心衰液体管理注意事项利尿剂的剂量应根据病人每天记录的尿量和体重加以调整，如体重增加0.5kg/d，则要增加利尿剂的剂量利尿的治疗目标是消除液体潴留的症状和体征（颈静脉怒张、肺部罗音和周围水肿的消失）心衰液体管理注意事项利尿剂的剂量应根据病人每天记录的尿量和体50This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.癫痫的护理癫痫的护理崂山神经内科癫痫的护理崂山神经内科51This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心力衰竭的疑难病例讨论课件52This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心力衰竭的疑难病例讨论课件53This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心力衰竭的疑难病例讨论课件54This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.护理措施一、一、保持呼吸道通畅 1.病人抽搐时，先解开病人领口，取出活动性假牙，使用舌钳，防止舌后坠，阻塞呼吸道同时取平卧头侧位，清除口鼻