感冒还是心衰？这般的咳嗽别不管！【第1375期】
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">点击上方小字</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;">就可</span>关注名家心讲堂<span style="color: black;">每日</span><span style="color: black;">颁布</span>的</span><span style="color: black;">信息</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2021年7月第4期 总第1375期</span></p><img src="https://mmbiz.qpic.cn/mmbiz_png/FIBZec7ucCiaNqqPu99RtKKZ2tWicNElXPjueOPco1G8vCxaaCSkIpej9bk6DOeH9aD7QXhiaZKia1pWickTKoDnsug/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/oC1WL2FJFGzqomuhHPex2noHH9HNfZek3AyMSMsV5hDKPB7nAeOiacHVCAiapKbAWic8wIwTVBNVsXyeSobLibEBdg/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">78岁的朱老先生患冠心病<span style="color: black;">数年</span>，平时用<span style="color: black;">药品</span>维持，病情稳定。近<span style="color: black;">1星期</span>来，他总是<span style="color: black;">没</span>缘<span style="color: black;">没</span>故地咳嗽，<span style="color: black;">无</span>痰，<span style="color: black;">亦</span>不发热。<span style="color: black;">夜晚</span>睡觉时，咳嗽症状会<span style="color: black;">显著</span>加重，他<span style="color: black;">必要</span>坐起来，才感觉好受<span style="color: black;">有些</span>。起初，朱老先生以为咳嗽是感冒<span style="color: black;">导致</span>，便吃了些消炎药。不料几天以后，他的咳嗽不仅<span style="color: black;">无</span>好转，反而越发严重，<span style="color: black;">夜晚</span>一躺下来就咳嗽，只能坐着。家人很着急，连忙陪老人去医院就诊。经<span style="color: black;">检测</span>，<span style="color: black;">大夫</span>诊断朱老先生患了左心衰，经抗心衰治疗后，咳嗽便缓解了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> <strong style="color: blue;">心脏病<span style="color: black;">亦</span>会<span style="color: black;">导致</span>咳嗽</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">心衰分左心衰、右心衰和全心衰。左心衰<span style="color: black;">初期</span><span style="color: black;">重点</span>表现为频繁咳嗽(多为干咳)、胸闷、气短，活动后尤其<span style="color: black;">显著</span>，这种咳嗽在临床上被<span style="color: black;">叫作</span>为“心源性咳嗽”。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> <span style="color: black;">因为</span>老年人常合并<span style="color: black;">身患</span>多种慢性<span style="color: black;">呼气</span>道<span style="color: black;">疾患</span>，如慢性支气管炎、肺气肿等，故当左心衰以<span style="color: black;">呼气</span>道症状(心源性咳嗽)为<span style="color: black;">重点</span>表现时，常被误认为是支气管炎或哮喘<span style="color: black;">爆发</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">心源性咳嗽与体位关系密切，卧位时症状加重，坐位时症状减轻，且常在夜间<span style="color: black;">爆发</span>。除合并感染外，心源性咳嗽<span style="color: black;">通常</span><span style="color: black;">没</span>发热或脓痰，抗生素疗效不<span style="color: black;">显著</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"> <span style="color: black;">那些</span>人最容易<span style="color: black;">出现</span>心衰？</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 心衰分为急性心衰和慢性心衰两大类。急性心衰来得快、病情重、紧急处理之后恢复得<span style="color: black;">亦</span>快。慢性心衰是一种慢性<span style="color: black;">疾患</span>状态，适当<span style="color: black;">药品</span>能舒缓病情，<span style="color: black;">加强</span>心功能并延长生命，但<span style="color: black;">不可</span>恢复正常心功能状态。两者的<span style="color: black;">一起</span>点是常常都<span style="color: black;">出现</span>于有心脏结构、功能<span style="color: black;">反常</span>的<span style="color: black;">病人</span>。</span><span style="color: black;"><span style="color: black;">然则</span>心脏结构、功能正常的人<span style="color: black;">亦</span>有可能<span style="color: black;">出现</span>急性心衰。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/oC1WL2FJFGzmwNadAehgFr5VOgnRzTRGkAjGh0pN8jln3zrA1FcZECYa4k5KjHWtV5LO494myBicxRuW4kj3OjA/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 当然还是有心脏病的<span style="color: black;">病人</span><span style="color: black;">更易</span><span style="color: black;">出现</span>心衰，<span style="color: black;">包含</span>冠心病、高血压、老年性退行性心瓣膜病、风湿性心瓣膜病、扩张型心肌病、急性重症心肌炎等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">平常</span>的诱发<span style="color: black;">原因</span>为：慢性心衰治疗缺乏依从性、心脏容量超负荷、肺部感染、严重颅脑损害、剧烈的精神心理紧张、大手术后、肾功能<span style="color: black;">衰退</span>、急性<span style="color: black;">心率</span>失常、支气管哮喘<span style="color: black;">爆发</span>、肺动脉栓塞、高心排血量<span style="color: black;">综合症</span>、应用负性肌力<span style="color: black;">药品</span>(如美托洛尔、比索洛尔、阿替洛尔等)等。最<span style="color: black;">平常</span>的是肺部感染，<span style="color: black;">或</span>是一次感冒就可能使原有的心脏病雪上加霜、心脏不堪重负而<span style="color: black;">忽然</span><span style="color: black;">出现</span>急性心力<span style="color: black;">衰尽</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"> 7大特征<span style="color: black;">帮忙</span>识别心衰</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1.稍活动或劳动，即感心慌、胸闷、气促。<span style="color: black;">呼气</span>系统<span style="color: black;">疾患</span><span style="color: black;">导致</span>的咳嗽，常伴有咳痰，<span style="color: black;">乃至</span>咳痰的颜色有改变，还可能会伴有发烧等。而心功能不全<span style="color: black;">导致</span>的咳嗽，多半跟体力活动<span style="color: black;">关联</span>，<span style="color: black;">例如</span>稍微活动，咳嗽的症状就会加重。<span style="color: black;">由于</span>活动会使心脏的<span style="color: black;">包袱</span>加重，相应地咳嗽<span style="color: black;">亦</span>会加重，但<span style="color: black;">休憩</span>之后会得到缓解。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 2.尿量减少，<span style="color: black;">短期</span>内体重<span style="color: black;">显著</span><span style="color: black;">增多</span>。若<span style="color: black;">没</span>肾脏疾患，多提示心脏功能已<span style="color: black;">处在</span>失代偿状态。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/oC1WL2FJFGzqomuhHPex2noHH9HNfZekpE1PJOlXooYU7OmsrLatQHzJ7UV8OlcaMypflWlicgt3pDQmjTHuICQ/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3.夜间<span style="color: black;">忽然</span>憋醒，或伴有<span style="color: black;">呼气</span>急促或喘息，坐起来后症状<span style="color: black;">火速</span>消失。<span style="color: black;">更加多</span>心脑血管精品<span style="color: black;">文案</span>，请关注<span style="color: black;">微X</span>公众号：名家心讲堂。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">4.<span style="color: black;">不可</span>完全平卧，平卧后即感到胸闷气短，需垫高枕头或取半卧位才舒适。心功能不全<span style="color: black;">导致</span>的咳嗽与体位<span style="color: black;">关联</span>。一躺下，回心血量<span style="color: black;">增多</span>，就会加重心脏的<span style="color: black;">包袱</span>，心衰的症状就会加重，咳嗽<span style="color: black;">亦</span>就会<span style="color: black;">显著</span>加重；<span style="color: black;">然则</span>一坐起来，回心血量减少，这种咳嗽就会好转。<span style="color: black;">显现</span>这些症状时，说明心衰症状已进一步加重。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 5.咳嗽、咯少量白痰。当<span style="color: black;">出现</span>急性左心衰时，<span style="color: black;">重点</span>表现为咯<span style="color: black;">海量</span>白色<span style="color: black;">泡泡</span>或洗肉水样痰，并伴有口唇或面色青紫、大汗淋漓、喘息等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 6.心衰<span style="color: black;">出现</span>以后，因大脑供血不足，不少老年病人会<span style="color: black;">显现</span>精神症状，如心情烦躁、焦虑、恐惧、嗜睡等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">7.当病人<span style="color: black;">出现</span>右心衰或全心衰(左、右心功能不全)时，因全身静脉回流不畅，会<span style="color: black;">显现</span>颈部血管(静脉)<span style="color: black;">显著</span>充盈或怒张、肝脾肿大、下肢或全身水肿等静脉淤血症状。此时，病人可能感觉不适症状较以前有所好转，但<span style="color: black;">实质</span>上却是病情加重的表现。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"> 左心衰急救策略</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">当病人<span style="color: black;">出现</span>急性左心衰时，家属在拨打120急救<span style="color: black;">tel</span>后，可采取<span style="color: black;">有些</span>急救<span style="color: black;">办法</span>，减轻心衰症状：1.取半卧位，以减少回心血量，缓解<span style="color: black;">呼气</span>困难；2.若家里配备氧气，可立即给病人吸氧；3.让病人舌下含服硝酸甘油或消心痛，以扩张血管，减轻心脏负荷；4.若病人有焦虑或烦躁症状，应给予适当安慰。若有可能，可给予少量镇静剂。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">源自</span>：健客网</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">---------------------------------------</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">·感谢您对名家心讲堂的关注和支持。</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">·免责声明：</span></strong><strong style="color: blue;"><span style="color: black;">本<span style="color: black;">网</span>和公共<span style="color: black;">微X</span>平台上<span style="color: black;">供给</span>的自我健康管理的理念、知识和<span style="color: black;">办法</span>是从预防<span style="color: black;">疾患</span>的<span style="color: black;">方向</span>出发，使亚健康人群和轻中度的心脑血管病<span style="color: black;">病人</span>加强危险<span style="color: black;">原因</span>的关注，<span style="color: black;">目的</span>是延缓或降低突发性重症的<span style="color: black;">出现</span>。</span></strong><strong style="color: blue;"><span style="color: black;"><span style="color: black;">不可</span>替代医院的<span style="color: black;">检测</span>和治疗。</span></strong><strong style="color: blue;"><span style="color: black;">请接受医院治疗的<span style="color: black;">病人</span>，谨遵医嘱。</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">·<span style="color: black;">咱们</span>尊重原创。</span></strong><strong style="color: blue;"><span style="color: black;">本平台部分<span style="color: black;">文案</span>、<span style="color: black;">照片</span><span style="color: black;">源自</span>或改编自互联网及其他公众</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">平台，<span style="color: black;">重点</span>目的在于分享信息，让<span style="color: black;">更加多</span>人<span style="color: black;">得到</span>健康<span style="color: black;">新闻</span>，版权归原作者所有，内容仅供读者参考，如有侵犯您的权益或版权请<span style="color: black;">即时</span><span style="color: black;">通知</span><span style="color: black;">咱们</span>，<span style="color: black;">咱们</span>将尽快删除！</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">·扫描下面二维码<span style="color: black;">就可</span>关注<strong style="color: blue;"><span style="color: black;">名家心讲堂</span></strong>公众<span style="color: black;">微X</span>号。</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz/oC1WL2FJFGzuD6ibXVTzBvfFyp0Gfic6RxJEfDfdgflOiaUXU5WszlYK50UVc856Avx74aQYCzjfMwYpBSZNbDnlQ/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
页:
[1]