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重症心肌炎护理PPT课件.ppt

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1、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller

2、and DS18B20 temperature sensor.重症心肌炎This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the

3、 system are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报患者: ,女 55岁 澳大利 亚 人主 诉 : 发热、咳嗽 2天,突发意识不清伴肢体抽搐、牙关紧闭半天。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digit

4、al temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报现 病史 : 患者 2天前( 2014-12-10)无明显诱因出现发热、咳嗽, 12日中午突然出现意识不清伴肢体抽搐、牙关紧闭,头部左倾及强直,双拳紧握,四肢抽搐,伴小便失禁,持续约 20-30分钟未见缓解,由 120送至我院, T38.6 , BP 149/74mmHg,SpO97

5、%,给予地西泮 10mg iv,四肢抽搐逐渐缓解,行颅脑 CT示右侧颞叶局部高密度影 ,考虑为 1.癫痫持续状态 2.颅内占位出血?给予清除自由基、促进脑代谢、抑酸保护胃黏膜、抗感染、补液及对症支持等综合治疗。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sen

6、sor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报2014-12-14 08: 40患者突然烦躁不安,呼吸急促,不能平卧,考虑急性左心衰可能性大,遂给予强心利尿剂; 08: 45左右患者 SpO2逐渐下降至 80%左右,血压148/89mmHg,突然出现意识丧失、呼之不应、心跳、呼吸停止;查体口唇、面色紫绀,口腔内有粉红色泡沫样痰咳出,呈昏迷状,对光反射消失。随立刻给

7、予吸痰清理气道分泌物、心脏胸外按压。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C5

8、1 microcontroller and DS18B20 temperature sensor.病例汇报09:01心电监护示 SpO2持续下降至测不出,血压下降,给予多巴胺、肾上腺素等药物应用,持续心脏按压,面罩辅助呼吸,患者心电监护示:室颤,给予电除颤后继续胸外心脏按压,患者逐渐出现自主呼吸,呼吸表浅,呼吸次数 5次左右, 09: 16立刻行气管插管后接呼吸机辅助呼吸,呼吸模式为 SIMV+VCV模式患者病情稳定后于 2014年 12月 13日 10时 44分由神经内 5科转入心内 1科。This paper mainly introduces the design of an intel

9、ligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报既往史 : 既往食用面包后呕吐病

10、史 6年余,自诉对“ wheat” 过敏,未明确诊断及有效治疗。 10天前至中国, 1天前晚间曾饮酒。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core co

11、mponents of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报辅 助 检查 :2014.12.12:白细胞 10.65X109/L肌酸激酶同工酶(干) 21.60 ng/ml ( 0-4.3 ng/ml )肌红蛋白定量 500.0 ng/ml ( 0-107 ng/ml )肌钙蛋白 I定量 5.54 ng/ml ( 0-1.0 ng/ml )B型钠尿肽 (急 ) 161.0 pg/ml ( 0-100 pg/ml )血气全项 :二氧化碳分压 57.00 mmHg ,氧分压 53.00

12、mmHg颅脑 CT右侧鞍旁区类圆形混杂密度灶(未见报告)。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system

13、 are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报入院 诊 断:1.心肺复苏后 重症心肌炎?心肌梗死? 急性左心衰 2.癫痫 3.颅内占位 4.肺部感染This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital tempe

14、rature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病例汇报治 疗经过 :患者心跳、呼吸停止,经抢救后复苏成功转入我科 CCU病房,给予呼吸机辅助呼吸,给予抗病毒(黄芪、利巴韦林)、抗细菌及病毒感染(泰能)、调节免疫治疗(静注人免疫球蛋白 )、激素(甲强龙)、利尿、补钾、升压(多巴胺)、镇静(吗啡、力月西)、营养支持(卡文)等对症支持治疗,患者逐渐意识清醒,

15、肢体活动自如,可与患者家属自主交流, 12-17患者所属保险公司要求转入香港医院继续治疗。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core componen

16、ts of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心肌炎的定义定 义 : 各种因素引起的以心肌细胞坏死或间质炎性细胞浸润为主要表现的心肌炎症性疾病。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus dig

17、ital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.心肌炎的病因感染性 非感染 性病因病毒感染细菌真菌螺旋体立克次体药物化学物理 过敏变态柯萨奇 B 组病毒This paper mainly introduces the design of an intelligent temperature control system which r

18、ealizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病毒性心肌炎定 义 : 病毒性心肌炎是病毒侵犯心肌 , 使得心肌间质水肿充血 , 以心肌局灶性或弥漫性炎性病变为主要表现的

19、疾病。急性重症心肌炎定 义 : 是病毒性心肌炎的严重类型 , 临床表现为心源性休克、心力衰竭和严重心律失常易造成心、脑、肺、肾、肝等多脏器功能损害,是进展迅速的临床急危重症,病情凶险,死亡率高。重症心肌炎分为猝死型(爆发型)、心源性休克型、急性心力衰竭型和反复阿斯发作型。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using sin

20、gle bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.病毒性心肌炎病因肠道呼吸道劳 累妊娠酗酒营 养不良缺氧寒冷This paper mainly introduces the design of an intelligent temperature control system which realizes the

21、function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.患者体重较轻, 10天前来中国旅游,旅途疲劳,由于环境因素、劳累因素等导致感染以发热、腹泻起病,检验降钙素原升高。患者无明显胸痛,既往无高血压,无

22、糖尿病等冠心病危险因素,无典型 ACS演变过程,查体颈静脉怒张,肝颈回流征阳性,考虑重症心肌炎可能性大,心衰合并继发性肺部感染。劳 累营 养不良 寒冷 肠 道 呼吸 道This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and singl

23、e chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.重症心肌炎:病理 病变广泛而严重,多呈弥漫性心肌炎,心肌纤维变性坏死。症状 呈爆发型,起病 12日内出现心功能不全或突发心源性休克。极度乏力、头晕、烦躁、呕吐、心前区痛或压迫感,有的呼吸困难、大汗淋漓、皮肤湿冷。体征 面苍、唇绀、四肢凉、指趾发绀、脉弱或摸不到、血压低或测不出;可出现奔马律、心动过速或过缓、或严重心律失常;肺部有啰音,颈静脉怒张 ,肝常迅速增大,可出现

24、急性左心衰、肺水肿 。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 micro

25、controller and DS18B20 temperature sensor.临床表现1.症状:取决于病变的广泛程度与部位。重者可猝死,轻者几无症状。2.前驱感染: 1 3周前,有上感或肠道感染史 ,如发热、全身倦怠等 “ 感冒 ” 样症状或恶心、呕吐、腹泻等消化道症状。3.全身症状:心悸、胸闷、心前区隐痛、乏力、气急4.心脏受累:心衰、心源性休克、阿 -斯、猝死等90左右的病人以心律失常为主诉就诊 This paper mainly introduces the design of an intelligent temperature control system which real

26、izes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.临床特点1. 起病急骤,病情发展迅速。数小时或 1-2 天即出现急性心力衰竭或心源性休克或晕厥发作 ,可发生猝死。2. 多以心外

27、症状为首发表现。国内外相关报道,重症心肌炎首发症状多为发热、乏力、咳嗽或腹痛、腹胀、呕吐等,亦有以头痛、晕厥、惊厥等为首发症状者。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcompute

28、r. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.临床特点3. 急性心力衰竭:呼吸、心率增快,烦躁不安、尿少、浮肿、肝脏迅速增大4. 心源性休克:面色苍白、皮肤发花、肢端凉、脉搏细弱、血压降低5. 阿 -斯综合征:面色苍白、突然意识丧失、 抽搐This paper mainly introduces the design of an intelligent temperature control system which realizes the fun

29、ction of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.辅助检查实验室检查: 血常规: WBC心肌酶谱: CK-MB升高肌钙蛋白 T ( cTnT)、肌钙蛋白 (IcTnI)升高CRP ESR病毒学检查Thi

30、s paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and

31、 DS18B20 temperature sensor.2014-12-14B型钠尿肽 723.0 pg/ml (参考值 0-100 pg/ml )C反应蛋白 123.00 mg/L (参考值 10 mg/L )血沉 42 mm/h (参考值 0-15 mm/h)降钙素原 2.220 ng/ml (参考值 0-0.046 ng/ml)This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature meas

32、urement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.BNP+心梗三联This paper mainly introduces the design of an intelligent temperature control system which re

33、alizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introduces the design of an intelligent temp

34、erature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.辅助检查X线检查 : 心脏可轻、中度增大,透视下心脏搏动减弱。

35、有心包积液时可呈烧瓶样改变。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 mi

36、crocontroller and DS18B20 temperature sensor.辅助检查心 电图 : 常见 ST-T改变和各种心律失常,合并急性心包炎的患者可有 aVR 导联以外 ST 段广泛抬高,严重时有病理性 Q波。可出现各型心律失常,特别是室性心律失常和房室传导阻滞。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by usi

37、ng single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.辅助检查2014-12-14 9:08 发 生室 颤This paper mainly introduces the design of an intelligent temperature control system which realizes t

38、he function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.辅助检查2014-12-14 9:35 复苏成功This paper mainly introduces the design of an

39、intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.辅助检查超声心 动图 : 心肌

40、收缩及舒张功能异常 ,节段性或弥漫性室壁运动减弱,心脏扩大或附壁血栓。合并心 包炎者可有 心 包积液。心肌活 检 : 可确诊This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.

41、The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.室壁搏 动 减弱 左室增大 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature s

42、ensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.诊断1999年成人急性心肌炎 诊 断参考 标 准 :一 .病史与体征:病毒感染后 3周出现心脏症状二 .上述感染内出现下列心律失常或 ECG改变1.窦速、 AVB、窦房阻滞或束支阻滞。2.多源成对室性早搏,自主性房性或交界性心动过速,阵发性或非阵发性室性心动过速。3.二个以上导联 ST段呈水平或下斜型下移 0.05mv或

43、ST段异常抬高或出现异常 Q波。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.三 .心肌损伤的参考指标 肌钙蛋白 I或 T, CK MB明显增高。超声心动图或核素扫描。四 .病毒学依据1.检出病毒2.病毒抗体3.病毒特异性 IgM同时具有上述一、二( 1、 2、 3中任一项)、三中任何二项。在排除其他原因心肌疾病后可诊断。如具有四中的第 1项者可从病原学上确诊急性病毒性心肌炎;具有四中的第 2、 3项者,只能拟诊为急性病毒性心肌炎。

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