是指病人自觉心中悸动.ppt

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1、1,心悸,Palpitation,2,Palpitation,DefinitionPalpitation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,3,CauseofDiseaseandPathomechanismPalpitation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,4,Analysesofpathologica

2、lconditions心虚胆怯(timidityduetoheart-deficiency)心血不足(insufficiencyofheartblood)阴虚火旺(flaringoffireduetoyin-asthenia)心阳不振(inactivationofheart-yang)水饮凌心(fluidretentioninvadingheart)心血瘀阻(stasisofheartblood),Palpitation,5,AnalysesofpathologicalconditionsTimidityduetoheart-deficiency心悸，善惊易恐，坐卧不安，少寐多梦，舌苔薄白或如

3、常，脉象动数或虚弦。Insufficiencyofheartblood心悸，头晕，面色不华，倦怠乏力，舌质淡红，脉象细弱。,Palpitation,6,AnalysesofpathologicalconditionsFlaringoffireduetoyin-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。Inactivationofheart-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,7,AnalysesofpathologicalconditionsFluidretentionin

4、vadingheart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。Stasisofheartblood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,8,Problemsofpatients,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,Nursinggoals,9,NursinginterventionsTimidityduetoheart-deficiencyPrincipleofnursing：镇惊定志，养心安神Entiretynursing,Lifeca

5、re:Dietarycare:Drugscare:Othernursingmethods:,Palpitation,10,NursinginterventionsInsufficiencyofheartbloodPrincipleofnursing：补血养心，益气安神Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Palpitation,11,NursinginterventionsFlaringoffireduetoyin-astheniaPrincipleofnursing：滋阴请火，养心安神Entirety

6、nursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Palpitation,12,NursinginterventionsInactivationofheart-yangPrincipleofnursing：温补心阳，安神定悸Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Palpitation,13,NursinginterventionsFluidretentioninvadingheartPrincipleofnursing：振奋心阳，化气行水E

7、ntiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Palpitation,14,NursinginterventionsStasisofheartbloodPrincipleofnursing：活血化瘀，理气通结Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Palpitation,15,NursingevaluationIntroductiononhealth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

8、等。保证充足的休息与睡眠是减轻病情的重要条件。,Palpitation,16,17,胸痹,Chestblockage,18,Chestblockage,Definition,Chestblockage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,19,CauseofDiseaseandPathomechanism,Chestblockage,Chestblockage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

9、要表现为本虚标实，虚实夹杂。,20,Analysesofpathologicalconditions心血痹阻：stasisofheartblood痰浊壅塞：stagnationandobstructionofturbidphlegm阴寒凝滞：stagnationofyin-cold心肾阴虚：astheniaofcardiacandrenalyin气阴两虚：astheniaofbothqiandyin阳气虚衰：declinationofyangqi,Chestblockage,21,AnalysesofpathologicalconditionsStasisofheartblood胸部刺痛，固定

10、不移，入夜更甚，时或心悸不宁，胸闷气短，舌紫暗，脉沉涩。Stagnationandobstructionofturbidphlegm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。,Chestblockage,22,AnalysesofpathologicalconditionsStagnationofyin-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。Astheniaofcardiacandrenalyin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。,Chestblocka

11、ge,23,AnalysesofpathologicalconditionsAstheniaofbothqiandyin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。Declinationofyangqi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。,Chestblockage,24,Problemsofpatients,Chestblockage,Nursinggoals,胸痛恐惧知识缺乏活动无耐力,25,NursinginterventionsStasisofhe

12、artbloodPrincipleofnursing：活血化瘀，通络止痛Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Chestblockage,26,NursinginterventionsStagnationandobstructionofturbidphlegmPrincipleofnursing：通阳泄浊，豁痰开结Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Chestblockage,27,Nursinginterve

13、ntionsStagnationofyin-coldPrincipleofnursing：辛温通阳，开痹散结Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Chestblockage,28,NursinginterventionsAstheniaofcardiacandrenalyinPrincipleofnursing：滋阴益肾，养心安神Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Chestblockage,29,Nursin

14、ginterventionsAstheniaofbothqiandyinPrincipleofnursing：益气养阴，活血通络Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Chestblockage,30,NursinginterventionsDeclinationofyangqiPrincipleofnursing：益气通阳，活血通络Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Chestblockage,31,Nursi

15、ngevaluationIntroductiononhealth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。,Chestblockage,32,眩晕,Dizziness/Vertigo,33,Dizziness/Vertigo,Definition眩(blurredvision)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。,34,Caus

16、eofDiseaseandPathomechanism肝阳上亢：hyperactivityofliver-yang肾精不足：deficiencyofrenalessence气血亏虚：astheniaofbothqiandblood痰浊中阻：turbidphlegmobstructinginmidst瘀血内阻：interiorretentionofbloodstasisDizziness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,35,AnalysesofpathologicalconditionsHyp

17、eractivityofliver-yangAstheniaofbothqiandbloodDeficiencyofrenalessenceTurbidphlegmobstructinginmidst瘀血阻络：bloodstasisobstructingcollaterals,Dizziness/Vertigo,36,AnalysesofpathologicalconditionsHyperactivityofliver-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。Astheniaofbothqiandblood眩晕动则加剧

18、，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,37,AnalysesofpathologicalconditionsDeficiencyofrenalessence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,38,AnalysesofpathologicalconditionsTurbidphlegmobstructinginmidst眩晕而头重昏蒙，胸脘满闷，纳呆，恶心，体倦多寐，苔白

19、腻，脉濡滑。Bloodstasisobstructingcollaterals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,39,ProblemsofpatientsNursinggoals,Dizziness/Vertigo,40,NursinginterventionsHyperactivityofliver-yangPrincipleofnursing：平肝潜阳，滋补肝肾Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Dizzine

20、ss/Vertigo,41,NursinginterventionsAstheniaofbothqiandbloodPrincipleofnursing：补益气血，健运脾胃Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Dizziness/Vertigo,42,NursinginterventionsDeficiencyofrenalessencePrincipleofnursing：Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,

21、偏阴虚者补肾滋阴偏阳虚者补肾助阳,Dizziness/Vertigo,43,NursinginterventionsTurbidphlegmobstructinginmidstPrincipleofnursing：燥湿祛痰，健脾和胃Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Dizziness/Vertigo,44,NursinginterventionsBloodstasisobstructingcollateralsPrincipleofnursing：祛瘀通络，活血通窍Entiretynursing,Lifecare:Dietcare:Drugscare:Othernursingmethods:,Dizziness/Vertigo,45,NursingevaluationIntroductiononhealth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,46,