?Pulmonary heart disease treatment
of acute exacerbation
?Active control of respiratory tract infections; smooth, to improve
respiratory function; correction of hypoxia and hypercapnia; control
of respiratory and heart failure.
(A) control of infections reference sputum culture and drug
susceptibility testing antibiotics. In the absence of culture, the
environment and under infected sputum smear Gram stain selection of
antibiotics. -Hospital infection to Gram-positive bacteria in the
majority; nosocomial infections are mainly in gram-negative bacteria.
Or use both antibiotics. Commonly used with Penicillins,
aminoglycoside, Fluoroquinolones and cephalosporins. In principle,
selection of narrow-spectrum antibiotic selection of broad-spectrum
antibiotics, must pay attention to possible fungal infection.
Shandong University affiliated hospital of respiratory medicine Zhang
(2) open the respiratory tract, correct the hypoxia and hypercapnia
see this chapter VI respiratory failure.
(3) control heart failure and pulmonary heart disease treatment and
other heart disease treatment of mental and physical exhaustion have
their differences, because Cor pulmonale General active infection
control, improve the respiratory function after heart failure can be
improved. Patient polyuria, edema, swelling of the liver to fade out,
pain disappears. Without adding diuretics, but on the treatment of
invalid heavier patients may be appropriate to use diuretic, cardiac
or vascular dilatation.
1, diuretics have reduce blood volume reduction right heart load,
eliminate edema. Principles on the use of light, a small dose of
diuretics. Such as hydrochlorothiazide 25mg, 1-3 times/day; the
amount of urine when you need to add more than 10% potassium chloride
10ml used, 3 times/day or retaining potassium diuretics, such as
ammonia, benzene 100mg pteridine-50, 1-3 times/day. Serious and
urgent patients available row diuretic furosemide 20mg intramuscular
injection or oral. Diuretics application after low potassium, low
chlorine alkalosis, not easy to make a thick sputum expectoration and
blood concentration, should pay attention to prevention.
2. a person because of chronic pulmonary heart tonic hypoxia and
infection, Digitalis tolerance is very low, the effect of poor and
vulnerable to arrhythmia, and treatment of heart failure in General.
Tonic of dose should be short, about general dose of 1/2 or 2/3 the
amount of selection effects quickly and excretion of tonic, such as
toxic hair flower Glycoside k 0.125-0.25mg, or hair flower Glycoside
C 0.2-0.4mg plus so 10% dextrose injection in the vein of slow.
Medication before correcting the hypoxia, hypokalemia, avoid drug
toxicity. Hypoxemia, infection can be made faster heart rate increase,
it is not appropriate to strengthen the heart and the heart rate as a
measure of medicine clinical examination of the application and
indications. Application of the indications are: ٠infection has been
control, respiratory function has been improved, diuretics can not be
made good curative effect and bloated repeatedly; ڠheart failure
patients to right heart failure as the main performance without
significant acute infections; acute heart failure occurs.
3. application of the vasodilator vasodilator as mitigation and heart
before and after the load and reduce myocardial oxygen consumption,
increase myocardial contractility, on the part of refractory heart
failure has certain effects, but not so as to treat other heart
disease evident result. Specific substances and methods is available
in the third article in chapter II. Vasodilator in reducing pulmonary
artery pressure still have different views. Because there is no on
pulmonary selective drug in clinic. Vasodilator Drugs in the
expansion of the pulmonary artery and also expansion of arterial
blood pressure, often resulting in systemic circulation, reflex
enables increased heart rate, oxygen partial pressure decrease and
increase of carbon dioxide and other side effects. Limits General
vasodilator in clinical application of COR. A study concluded that
calcium antagonist, ligustrazine, have a certain effect on reducing
pulmonary arterial pressure without side effects and long-term
application of also being examined.
(4) control arrhythmia General cardiac arrhythmias following
treatment of pulmonary infections, hypoxia can disappear. If you
persist according to the selection of the type of arrhythmia.
(5) strengthening nursing job presenting more anxious, recurrent,
readmission, patients and their families, spiritual and economic
burden of immense intensify psychological care, increase the
confidence of patients for treatment, combined with medical care is
very important. At the same time because of the severity of the
complex and ever-changing, must strictly observe changes to
strengthen the monitoring of heart and lung function. Stand up and
take back to exclude respiratory secretions are to improve
ventilation features an effective measure.
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