晚期心力衰竭的症状是什么？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>您<span style="color: black;">身患</span>心力衰竭，并且对传统心脏疗法<span style="color: black;">再也不</span>有反应，并且您的症状越来越严重，则您可能<span style="color: black;">身患</span>晚期心脏病。 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在美国，大<span style="color: black;">大概</span> 620 万人<span style="color: black;">身患</span>心力衰竭，<span style="color: black;">况且</span>这一数字预计还会<span style="color: black;">提升</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因为</span>心力衰竭治疗的改进使<span style="color: black;">身患</span>这种<span style="color: black;">疾患</span>的人的<span style="color: black;">存活</span>时间大大延长，<span style="color: black;">因此呢</span>达到<span style="color: black;">疾患</span>晚期（<span style="color: black;">亦</span><span style="color: black;">叫作</span>为终末期、难治性或晚期心力衰竭）的人数——正在稳步增长。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力衰竭是一种缓慢<span style="color: black;">发展</span>的<span style="color: black;">疾患</span>，<span style="color: black;">倘若</span>不进行心脏移植，<span style="color: black;">能够</span><span style="color: black;">掌控</span>但<span style="color: black;">没</span>法治愈。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">幸运的是，医学进步已将生活质量<span style="color: black;">加强</span>到<span style="color: black;">这般</span>一种程度，即人们<span style="color: black;">能够</span>更充分地参与临终决策，如姑息治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本文<span style="color: black;">仔细</span>讨论了晚期心力衰竭。</p>
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<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">1、</span>高级<span style="color: black;">周期</span></h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在晚期心力衰竭中，心脏<span style="color: black;">再也不</span>泵出足够的血液，这要么是<span style="color: black;">由于</span>心脏<span style="color: black;">没</span>法充满足够的血液，要么是<span style="color: black;">由于</span>泵出的能量不足以满足身体的<span style="color: black;">必须</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心脏还在跳动，但它很虚弱<span style="color: black;">况且</span>受损了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">更<span style="color: black;">要紧</span>的是，身体<span style="color: black;">没</span>法<span style="color: black;">赔偿</span>心脏泵血量的减少。结果，液体经常回流到肺部、肝脏、腹部或腿部。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">晚期心力衰竭最<span style="color: black;">平常</span>的症状是<span style="color: black;">呼气</span>急促和<span style="color: black;">休憩</span>时胸痛，或在轻微运动时<span style="color: black;">显现</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">纽约心脏协会<span style="color: black;">归类</span>系统是衡量症状严重程度的最简单和最广泛<span style="color: black;">运用</span>的<span style="color: black;">办法</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">一级</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">身体活动不受限制</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">没</span>心力衰竭症状</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">二级</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">身体活动轻度受限</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力衰竭症状伴显着<span style="color: black;">疲劳</span>；<span style="color: black;">休憩</span>或轻度活动时舒适</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">三级</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">体力活动<span style="color: black;">显著</span>受限</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">轻度运动会<span style="color: black;">显现</span>心力衰竭症状；<span style="color: black;">仅在</span><span style="color: black;">休憩</span>时舒服</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">四级</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">对任何活动感到不适</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">休憩</span>时<span style="color: black;">显现</span>心力衰竭症状</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">另一个<span style="color: black;">归类</span>系统是美国心脏协会和美国心脏病学会的 A 到 D 分期系统。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在这个系统中，晚期心力衰竭是 D 期。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A 期：您已被诊断出<span style="color: black;">身患</span>冠状动脉<span style="color: black;">疾患</span>、高血压或糖尿病，但您尚未<span style="color: black;">显现</span>左心室肥大、心室变形或超声心动图功能受损。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">B 期：您<span style="color: black;">无</span>症状，但超声心动图<span style="color: black;">表示</span>左心室肥大和/或左心室功能受损。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">C 期：您有心力衰竭的症状，但<span style="color: black;">能够</span><span style="color: black;">经过</span>标准治疗来<span style="color: black;">掌控</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D 期（晚期或难治性）：尽管进行了最佳的<span style="color: black;">药品</span>治疗，您还是在极少的运动或<span style="color: black;">休憩</span>时<span style="color: black;">显现</span>症状，并且临床恶化<span style="color: black;">必须</span>反复住院治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当预期寿命预计为六个月或更短时，心力衰竭被认为是末期。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">姑息治疗或临终关怀和新的<span style="color: black;">科研</span>疗法<span style="color: black;">一般</span>在心力衰竭的最后<span style="color: black;">周期</span>进行讨论。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">2、</span>症状</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">左心衰竭的<span style="color: black;">平常</span>症状<span style="color: black;">包含</span>：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（1）胸痛</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（2）疲劳</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（3）弱点</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（4）<span style="color: black;">呼气</span>急促，尤其是在用力时</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（5）端坐<span style="color: black;">呼气</span>，或躺下时<span style="color: black;">呼气</span>急促</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（6）阵发性夜间<span style="color: black;">呼气</span>困难，或夜间因<span style="color: black;">呼气</span>急促而醒来</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（7）运动不耐受</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（8）快速或不规则的心跳</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（9）外周水肿，或脚、角、腿肿胀</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（10）体重<span style="color: black;">增多</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（11）恶心</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（12）<span style="color: black;">连续</span>咳嗽或喘息</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（13）排尿次数比平时多（<span style="color: black;">尿多</span>）或夜间（夜尿）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">小心</span>脏虚弱时，液体会在全身积聚，从而<span style="color: black;">导致</span>问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">症状<span style="color: black;">包含</span>脚、腿和/或腹部肿胀以及<span style="color: black;">呼气</span>急促。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">您可能还会感到恶心和食欲不振。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因为</span>血液循环不畅，其他<span style="color: black;">平常</span>的<span style="color: black;">疾患</span><span style="color: black;">发展</span>迹象<span style="color: black;">包含</span><span style="color: black;">头昏</span>或<span style="color: black;">头昏</span>以及手脚冰凉。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">随着心力衰竭的<span style="color: black;">发展</span>，这些<span style="color: black;">平常</span>症状会变得更糟，并且在晚期可能看起来有所不同。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">1、<span style="color: black;">呼气</span>急促</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">虚弱的心脏<span style="color: black;">没</span>法将血液向前泵出，<span style="color: black;">因此呢</span>血液会积压到肺部，<span style="color: black;">引起</span><span style="color: black;">呼气</span>困难。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在晚期心力衰竭<span style="color: black;">时期</span>，您可能会感到<span style="color: black;">呼气</span>急促或<span style="color: black;">呼气</span>困难，即使是极小的运动<span style="color: black;">亦</span>是如此。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这种<span style="color: black;">呼气</span>急促可能是<span style="color: black;">因为</span>心脏上和<span style="color: black;">周边</span>的液体超负荷<span style="color: black;">导致</span>的，并且可能感觉像窒息、窒息和<span style="color: black;">巴望</span>空气。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">2、浮肿</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">严重的心力衰竭会<span style="color: black;">引起</span>腿部和腹部的血液和液体汇集。身体<span style="color: black;">一般</span><span style="color: black;">能够</span>容纳体积的大幅<span style="color: black;">增多</span>，大约 5 升，但在严重的心力衰竭中，额外的液体足以扩张身体的细胞外隔室。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肿胀<span style="color: black;">一般</span>在脚和脚踝处最为<span style="color: black;">显著</span>，但腹水（肝脏和腹部<span style="color: black;">周边</span>积液）的发展预后尤其差。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">3、体重<span style="color: black;">忽然</span><span style="color: black;">增多</span></h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在心力衰竭恶化<span style="color: black;">时期</span>，身体因液体潴留而体重<span style="color: black;">快速</span><span style="color: black;">增多</span>的<span style="color: black;">状况</span>并不少见，有时一天体重会高达 5 磅或<span style="color: black;">更加多</span>。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">4、<span style="color: black;">睡觉</span>问题</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在晚期心力衰竭中，液体积聚在肺部，<span style="color: black;">必须</span><span style="color: black;">更加多</span>的利尿<span style="color: black;">药品</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">不幸的是，在心力衰竭的最后<span style="color: black;">周期</span>，当身体将液体<span style="color: black;">保存</span>系统踢到高速档时，会<span style="color: black;">显现</span>利尿剂抵抗。 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当您躺下时，肺部积液会向身体发出唤醒信号，以防止窒息。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这种现象<span style="color: black;">叫作</span>为阵发性夜间<span style="color: black;">呼气</span>困难。人们在夜间多次醒来或难以找到舒适的睡姿的<span style="color: black;">状况</span>并不少见。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">许多心力衰竭<span style="color: black;">病人</span><span style="color: black;">亦</span>有<span style="color: black;">睡觉</span><span style="color: black;">呼气</span>暂停，<span style="color: black;">因此呢</span><span style="color: black;">她们</span>可能会错误地归因于<span style="color: black;">她们</span>的症状。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>您<span style="color: black;">身患</span>心力衰竭并且经常在半夜醒来，这可能是心力衰竭恶化的迹象，<span style="color: black;">因此呢</span>您应该立即联系医疗保健<span style="color: black;">供给</span>者。 </p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">5、咳嗽和喘息</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肺部积液或肺水肿可<span style="color: black;">导致</span>咳嗽或气喘。在更严重的<span style="color: black;">状况</span>下，这些症状可能类似于哮喘，<span style="color: black;">因此呢</span><span style="color: black;">运用</span>术语心源性哮喘来描述这些症状。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">严重咳嗽、气喘和吐粉红色痰的症状<span style="color: black;">不该</span>掉以轻心，一旦发现这些症状，应立即<span style="color: black;">看病</span>。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">3、</span>治疗</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">症状的急性<span style="color: black;">爆发</span>可能<span style="color: black;">寓意</span>着您<span style="color: black;">身患</span>一种<span style="color: black;">叫作</span>为急性失代偿性心力衰竭 (ADHF) 的病症，这种病症可能<span style="color: black;">出现</span>在<span style="color: black;">疾患</span>的任何<span style="color: black;">周期</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>您的症状对<span style="color: black;">药品</span>变化<span style="color: black;">无</span>反应，则<span style="color: black;">显示</span>晚期心力衰竭。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span>时候，晚期心力衰竭的症状会在医院接受一个疗程后<span style="color: black;">显现</span>反应，出院后您会感觉好多了，但遗憾的是，有些人并<span style="color: black;">无</span>改善到<span style="color: black;">能够</span>仅靠口服<span style="color: black;">药品</span>回家的程度。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这在<span style="color: black;">必定</span>程度上是<span style="color: black;">因为</span>利尿剂<span style="color: black;">没</span>效，利尿剂<span style="color: black;">叫作</span>为利尿剂抵抗——或尿钠排泄和利尿减少——<span style="color: black;">因为</span>身体过度激活 SNS 系统——神经系统中<span style="color: black;">增多</span>心率、血压的部分、<span style="color: black;">呼气</span>频率和瞳孔<span style="color: black;">体积</span>——以及调节血压的 RAAS 系统。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">有时<span style="color: black;">药品</span>可能在<span style="color: black;">必定</span>程度上起<span style="color: black;">功效</span>，但会让您感觉更糟。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心输出量减少会恶化肾功能并激活 SNS 和 RAAS 系统，<span style="color: black;">加强</span>钠和水的潴留。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">曾经有用的利尿剂<span style="color: black;">实质</span>上<span style="color: black;">能够</span><span style="color: black;">经过</span>恶化肾脏的肾小球滤过率和低钠血症或低钠水平来加重心力衰竭。 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">利尿剂<span style="color: black;">亦</span>可能<span style="color: black;">导致</span>电解质<span style="color: black;">错乱</span>，使治疗进一步<span style="color: black;">繁杂</span>化。 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">那样</span>此时有<span style="color: black;">那些</span><span style="color: black;">选取</span>呢？您可能<span style="color: black;">必须</span>先进的治疗<span style="color: black;">办法</span>，例如：</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">1、<span style="color: black;">连续</span>静脉内 (IV) <span style="color: black;">药品</span>治疗：</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">连续</span>静脉内<span style="color: black;">药品</span>治疗用于<span style="color: black;">得到</span>部分缓解并<span style="color: black;">期盼</span><span style="color: black;">得到</span>更高生活质量的<span style="color: black;">病人</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">它们<span style="color: black;">一般</span>用作移植或姑息治疗的桥梁。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另外</span>，大<span style="color: black;">都数</span>保险<span style="color: black;">机构</span>都承保这项服务，<span style="color: black;">因此呢</span><span style="color: black;">针对</span><span style="color: black;">哪些</span><span style="color: black;">没</span>力承担其他临终治疗<span style="color: black;">选取</span>的人<span style="color: black;">来讲</span>，它<span style="color: black;">能够</span>广泛<span style="color: black;">运用</span>。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">2、机械循环支持（部分或全人工心脏）：</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">主动脉内球囊反搏 (IABP) 或心室辅助<span style="color: black;">安装</span> (VAD) <span style="color: black;">能够</span><span style="color: black;">帮忙</span>心脏泵血并有效地将血液<span style="color: black;">传送</span>到身体，但它们<span style="color: black;">重点</span>用作恢复或心脏移植。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">IABP 已<span style="color: black;">作为</span>最有效和广泛<span style="color: black;">运用</span>的循环辅助<span style="color: black;">安装</span>，但<span style="color: black;">安置</span>该<span style="color: black;">安装</span>所需的手术<span style="color: black;">拥有</span>侵入性，会带来血栓栓塞、<span style="color: black;">流血</span>和感染的<span style="color: black;">危害</span>。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">3、心脏移植：</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心脏移植是<span style="color: black;">药品</span>治疗难治性心力衰竭<span style="color: black;">病人</span>的首选治疗<span style="color: black;">办法</span>，但<span style="color: black;">必须</span>心脏移植的人比捐赠者多。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">按照</span>国际心肺移植学会的数据，接受心脏移植的人一年和三年的存活率分别约为 85% 和 79%。1个</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">没</span>论您<span style="color: black;">选取</span>哪种治疗<span style="color: black;">方法</span>，保持您的心力衰竭自我护理程序<span style="color: black;">针对</span>保持和改善您的生活质量至关<span style="color: black;">要紧</span>。这<span style="color: black;">包含</span>：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（1）将您的盐摄入量限制在<span style="color: black;">每日</span> 2,000 毫克钠</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（2）限制饮用水、苏打水、咖啡和汤等液体，以<span style="color: black;">帮忙</span>避免积液</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（3）记录您的体重和症状，并了解新药和现有<span style="color: black;">药品</span>的副<span style="color: black;">功效</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（4）接受肺炎和流感疫苗接种</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（5）继续治疗高血压和糖尿病等先前存在的健康<span style="color: black;">情况</span></p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">4、</span>预后</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力衰竭与非常高的发病率和死亡率<span style="color: black;">相关</span>。80% 的男性和 70% 的 65 岁以上被诊断<span style="color: black;">身患</span>心力衰竭的女性将在八年内死亡。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">D 期心力衰竭的预后更为严峻。尽管改进了特殊治疗<span style="color: black;">干涉</span><span style="color: black;">办法</span>，但难治性心力衰竭的一年死亡率约为 50%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">最<span style="color: black;">平常</span>的死亡<span style="color: black;">原由</span>是进行性心力衰竭，但猝死可能占所有死亡人数的 45%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另外</span>，与白人相比，黑人死于心力衰竭的可能性高 30%，这凸显了美国<span style="color: black;">连续</span>存在的健康差异。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">晚期心力衰竭的症状是心输出量严重低下的表现。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">以下迹象可能<span style="color: black;">显示</span>某人正在死于心力衰竭，<span style="color: black;">尤其</span>是<span style="color: black;">倘若</span>频繁住院和专门治疗<span style="color: black;">方法</span>未<span style="color: black;">引起</span>临床改善：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（1）早饱</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（2）没胃口</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（3）腹痛</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（4）恶心</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（5）咳粉红色痰</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（6）肾功能不全</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（7）健忘和记忆问题</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">5、</span>应对</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力衰竭会对您的心理和<span style="color: black;">心情</span>健康产生重大影响。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">愤怒、<span style="color: black;">哀痛</span>和恐惧的感觉是很自然的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">与您的<span style="color: black;">伴侣</span>和家人谈谈您的感受，并在必要时寻求专业<span style="color: black;">帮忙</span>，这可能会<span style="color: black;">帮忙</span>您感觉更好并避免做出您可能会<span style="color: black;">懊悔</span>的一时冲动的决定。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力衰竭的<span style="color: black;">发展</span>可能<span style="color: black;">没</span>法预测，<span style="color: black;">因此呢</span>很难<span style="color: black;">晓得</span>何时就临终关怀进行对话。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">尽早讨论事情很<span style="color: black;">要紧</span>，让人们有时间<span style="color: black;">思虑</span>治疗<span style="color: black;">方法</span>以及<span style="color: black;">她们</span><span style="color: black;">期盼</span>在生命的尽头得到照顾的<span style="color: black;">地区</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这可能会<span style="color: black;">帮忙</span><span style="color: black;">她们</span><span style="color: black;">得到</span>内心的平静和<span style="color: black;">掌控</span>感。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">虽然您对治疗<span style="color: black;">选取</span>和临终关怀<span style="color: black;">持有</span><span style="color: black;">最后</span>决定权，但<span style="color: black;">包含</span>可信赖的医疗保健专业人员和您的家人在内的<span style="color: black;">一起</span>决策<span style="color: black;">寓意</span>着您不必单独做出<span style="color: black;">要紧</span>决定。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>尽管采取了最好的自我保健和<span style="color: black;">药品</span>治疗，但您的心脏功能<span style="color: black;">无</span>改善或恶化，您可能不得不<span style="color: black;">思虑</span>其他<span style="color: black;">选取</span>，例如心脏手术、<span style="color: black;">连续</span>静脉输注<span style="color: black;">药品</span>和心脏移植。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">科研</span><span style="color: black;">显示</span>，当人们与<span style="color: black;">大夫</span>和家人<span style="color: black;">一块</span>做出临终决<span style="color: black;">按时</span>，<span style="color: black;">她们</span>会感到最快乐和最满意，这一过程<span style="color: black;">叫作</span>为<span style="color: black;">一起</span>决策。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">这里</span><span style="color: black;">时期</span>，您可能想要讨论临终关怀<span style="color: black;">办法</span>，例如姑息治疗和指定授权书。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">身患</span>晚期心力衰竭并<span style="color: black;">不易</span>，临终谈话<span style="color: black;">亦</span>很困难。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">虽然您可能会感到害怕或感觉自己正在失去<span style="color: black;">掌控</span>，但在这些困难时期依靠您的家人和<span style="color: black;">伴侣</span><span style="color: black;">能够</span><span style="color: black;">保证</span>您所有的临终需求和愿望都得到满足。</p>
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在遇到你之前，我对人世间是否有真正的圣人是怀疑的。 你的话语如春风拂面，让我感到无比温暖。
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