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充血性心力衰竭对各种治疗方法均无良好反应,心力衰竭症状持续存在或进行性加重,称为难治性(或顽固性)心力衰竭。主要见于终末期的严重器质性心脏病,但部分是由心内外因素、各种并发症,甚至治疗本身所引起。 1 心脏病本身方面的因素 1.1 需内科特殊治疗的心脏疾病 1.1.1 潜在的风湿性心脏炎:是年轻风湿性心脏瓣膜病病人难治性心力衰竭的重要原因。其临床特点:①经常感冒、咽痛或关节酸痛持续两周以上者;②低热、多汗、面色苍白、显著乏力、心悸、气短者;③持续窦性心动过速、P—R间期延长或伴房性、室性心律失常者;④心脏明显扩大、持续存在奔马律或心脏杂音易变者;⑤血清ASO增高、白细胞计数增
Congestive heart failure does not respond well to any treatment, and symptoms of heart failure persist or worsen, known as refractory (or refractory) heart failure. Mainly seen in the final stage of severe organic heart disease, but in part by the heart factor, various complications, and even the treatment itself. 1 factors of heart disease itself 1.1 Heart disease requiring special medical treatment 1.1.1 Potential rheumatic carditis: an important cause of refractory heart failure in patients with rheumatic heart disease. The clinical features: ① frequent cold, sore throat or joint pain sustained for more than two weeks; ② low fever, sweating, pale, significant fatigue, palpitations, shortness of breath; ③ continuous sinus tachycardia, P-R interval prolongation Or accompanying room, ventricular arrhythmia were; ④ significantly enlarged heart, persistent gallop or volatile heart murmur; ⑤ elevated serum levels of ASO, white blood cell count increased