2022年医学专题—查房-低心排(1).pptxVIP免费

SICU-1LowCardiacOutputSyndrome低心排综合征第一页，共二十四页。LowCardiacOutputSyndrome低心排综合征(LowCardiacOutputSyndrome，LCOS)，简称低心排，是心脏外科最严重的生理异常，正常人的心排出(páichū)量按每平方米面积计算，也就是心指数为3-4L/(min·m2)，如心指数降低至3L/(min·m2)以下而有周围血管收缩，组织灌注不足的现象，称为低心排出量综合征。第二页，共二十四页。1contents524observingandnursingcareTreatmentsclinicalmanifestationsCasesintroduction3causesofLCOS第三页，共二十四页。CasesintroductionName:ZhuChangyinGender:MaleAge:59Admissiontime:2017-08-06Operationtime:2017-08-17Maincomplaint:chesttightness,wheezefor4months姓名：祝长银性别：男年龄：59岁入院(rùyuàn)时间：2017-08-06手术时间：2017-08-17主诉：胸闷、憋喘4月余第四页，共二十四页。CasesintroductionDiagnosis:heartvalvestenosis,tricuspidregurgitationOperation:aorticvalvereplacement诊断(zhěnduàn)：主动脉瓣狭窄三尖瓣返流手术名称：主动脉瓣置换术第五页，共二十四页。Historyofpresentillness现病史(bìnɡshǐ)chesttightness胸闷,suppressasthma憋喘,cough咳嗽,sputum咳痰,withoutsignificantfactorsinAprilthisyeardiagnosis:pleuraleffusion,Afworse,nightorthopnea夜间(yèjiān)端坐呼吸,cannotlaydown.diagnosedwithheartvalvedisease.admittedtotheclinicwith"valvulardisease".第六页，共二十四页。pasthistory既往(jìwǎnɡ)史Diabetes（糖尿病）historyfor2years.Paroxysmalatrialfibrillation（阵发性房颤）for4months.第七页，共二十四页。Postoperativelowcardiacperformanc术后低心排表现(biǎoxiàn)theoxygensaturationreducedfrom98to88.CVP11-12，slowlyroseto21-22Bloodpressureisdownfrom130-140/80to110/70nourineatthesametimeHeartcolorultrasoundrevealed:noeffusionofpericardialfluid,asmallamountoffluidintherightsideofthethoraciccavity,theleftventricularwallmovinglower,EF38第八页，共二十四页。causesofLCOS低心排的原因(yuányīn)(1)Pulmonaryhypertension肺动脉高压(gāoyā)cardiacinsufficiency心功能差Arhythmia心律失常(xīnlǜshīchán)ɡunsuccessfulcorrectionofcardiacmalformation心脏畸形矫正不良第九页，共二十四页。causesofLCOS...