是指病人自觉心中悸动.ppt

1、1,心悸,Palpitation,2,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,3,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,4,Analyses of p

2、athological 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,5,Analyses of pathological conditions

3、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,6,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

4、淡白，脉象虚弱或沉细而数。,Palpitation,7,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,8,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,9,Nu

5、rsing 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,10,Nursing interventions Insufficiency of heart blood Principle of nursing：补血养心，益气安神 Entirety nursing,Life care: Diet care: Dru

6、gs care: Other nursing methods:,Palpitation,11,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,12,Nursing interventions Inactivation of heart-yang Principle of nursing ：温补心

7、阳，安神定悸 Entirety nursing,Life care: Diet care: Drugs care: Other nursing methods:,Palpitation,13,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,14,Nursing interventions Stasis o

8、f 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,15,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,16,17,胸痹,Chest blockage,18,Chest blockage,Defin

9、ition,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,19,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。,20,Analyses of pathological conditions 心血痹阻：stasis of hea

10、rt 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,21,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。 Sta

11、gnation 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,22,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,23,Ana

12、lyses 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,24,Problems of patients,Chest blockage,Nursing goals,胸痛 恐惧 知识缺乏 活动无耐力,25,Nursing intervent

13、ions 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,26,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:

14、Other nursing methods:,Chest blockage,27,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,28,Nursing interventions Asthenia of cardiac and renal yin Principle of nursing ：滋阴益肾，养心安神 En

15、tirety nursing,Life care: Diet care: Drugs care: Other nursing methods:,Chest blockage,29,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,30,Nursing interventions Declination of

16、 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,31,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,32,眩晕,Dizzine

17、ss / Vertigo,33,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。,34,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 p

18、hlegm 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,35,Analyses of pathological conditions Hyperactivity of liver-yang Asthenia of both qi and blood Deficiency of renal essence Turbid phlegm obstructing in

19、 midst 瘀血阻络：blood stasis obstructing collaterals,Dizziness / Vertigo,36,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,37,Analyses o

20、f 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,38,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，

21、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,Problems of patients Nursing goals,Dizziness / Vertigo,40,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,41,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,42,Nursing interventions Def