![\"5月12日，在英国伦敦，一名由于医院电子系统遭到病毒攻击而无法进行心脏手术的男子在医院外接受媒体采访\"](\"http://01luntan.com/ly_img/uimgs/1494773649525.jpg\" "\\"5月12日，在英国伦敦，一名由于医院电子系统遭到病毒攻击而无法进行心脏手术的男子在医院外接受媒体采访\\"")
5月12日，在英国伦敦，一名由于医院电子系统遭到病毒攻击而无法进行心脏手术的男子在医院外接受媒体采访
关于此事，我们看网友怎么评论：
Aip图的Miko：太过了，触及伦理底线
无望门：熊猫烧香作者，完全可以去美国一些特别部门，还是很有道德的
一饼爸b安枫：回复@良Ren何时归:有正有斜，但是触及生命就无法原谅了
9日前做了心包剥离手术，出院前检查说有心包积液，术前没有积液，心包剥离后怎么还出现心包积液了呢？
为什么出现心包积液？怎么治疗？
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心前区偶发疼痛，运动后胸闷气短。无力。
能否胸腔镜或微创手术。不做开胸截骨手术。
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孩子现在需要手术吗？多会手术合适呢？
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请给我一些治疗上的建议,目前病情是否需要手术？
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法洛氏四联症，动脉导管未闭，肺动脉狭窄
复杂性先心能治好不？
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1.病因及致病菌：可由外伤所致心包直接污染发病。平时所见多为继发于皮肤、软组织、骨髓等急性感染所致败血症或脓毒血症。亦有部分继发于膈下化脓性感染。致病菌以葡萄球菌、链球菌、肺炎双球菌等常见。
2.病理：病变早期为心包充血、水肿、大量白血球浸润、纤维素沉积，可侵犯心肌引起心肌表面化脓性炎症。心包内渗出液含多形核白血球，呈米渣汁或脓血样，渗出多且速度快时，可发生急性心包填塞。在急性发病期治疗得当，可炎症消退而愈，否则病情迁延可转为慢性心包炎。
3.临床表现及体征：患者多为幼儿或青少年。起病多有发冷、发热、多汗、周身倦怠、食欲减退及贫血等全身感染征象，可有不同程度心慌、气短、咳嗽、不能平卧及胸骨后疼痛不适。
体格检查，早期心前区可听到心包摩擦音，随心包内渗液增加，心界扩大，心尖搏动消失，心音遥远，脉压变窄，心率加快，颈静脉怒张，肝大等。
4.有关诊断检查：
x线：表现心包积液征，心影呈烧瓶样，心缘各孤消失，心脏搏动减弱等。
心电图：各导联呈现qrs波群低电压，标准肢体导联st段抬高，t波倒置。
超声心动图：心包腔内大量液体反射波。
心包穿刺：抽出有脓性液体即可诊断，穿刺物送涂片和细菌培养，明确致病菌。
（一）症状
1.胸痛 是急性心包炎最主要症状，多见于急性特发性心包炎及感染性心包炎的纤维蛋白渗出阶段。疼痛的性质和部位是易变的，常位于胸骨后或心前区，可放射至颈部和背部，呈锐痛，偶可位于上腹部，类似“急腹症”；或与心肌梗死缺血性疼痛相似，呈钝痛或压榨性痛并放射至左上肢；或随每次心脏跳动而发生刺痛。疼痛可因心包和胸膜炎症受累两个因素引起，也可能与心包腔积液时心包牵张因素有关。疼痛多在卧位、咳嗽、深吸气时加重，前倾位时减轻。
2.呼吸困难 是心包渗液时最突出的症状，为避免心包和胸膜疼痛而产生呼吸变浅变速。
呼吸困难也可因发热、大量心包积液导致心腔压塞、邻近支气管、肺组织受压而加重，表现为面色苍白、烦躁不安、胸闷、大汗淋漓等。患者常采取坐位，身体前倾，使心包积液向下、向前移位以减轻其对心脏及邻近脏器的压迫，从而缓解症状。
3.全身症状 可伴有潜在的全身疾病如结核、肿瘤、尿毒症所致的咳嗽、咳痰、贫血、体重下降等症状。
（二）体征
1.心包摩擦音
为急性纤维蛋白性心包炎特异性体征，炎症导致壁层与脏层心包变得粗糙，在心脏活动时相互摩擦产生的声音，似皮革摩擦呈搔刮样、粗糙的高频声音。心包摩擦音的特点是瞬息可变，通常使用隔膜性胸件在胸骨左缘3一4肋间、胸骨下段和剑突附近易听到。其强度受呼吸和体位影响，深吸气或前倾坐位摩擦音增强。当心包内出现渗液，将两层心包完全分开时，心包摩擦音消失；如两层心包有部分粘连，虽有心包积液，有时仍可闻及摩擦音。心包摩擦音应与胸膜摩擦音或听诊器胸件未压紧皮肤所产生的嘎吱音相鉴别；而单相心包摩擦音需与三尖瓣或二尖瓣反流性收缩期杂音相鉴别。
2.心包积液
症状的出现与积液的量和速度有关，而与积液性质无关。当心包积液达200-300ml以上或积液迅速积聚时出现下列体征：①心脏体征：心脏搏动减弱或消失，心浊音界向两侧扩大，心音轻而远，心率快，少数人在胸骨左缘3-4肋间可听到舒张早期额外音（心包叩击音），此音在第二心音后0.1-0.13s，高调呈拍击样，是由于心室舒张时受心包积液的限制，血液突然终止形成旋涡和冲击心室壁产生震动所致。②左肺受压迫征：大量心包积液时，心脏向左后移位，压迫左肺，引起左肺下叶不张，在左肩胛下角区出现肺实变表现，称之为ewart征。③心脏压塞征：大量心包积液或积液迅速积聚，即使积液仅150～200ml，引起心包内压力超过20～30mmhg时即可产生急性心包压塞征，表现为心动过速、心血排量下降、发绀、呼吸困难、收缩压下降甚至休克。如积液为缓慢积聚过程，也可产生慢性心脏压塞征，表现为静脉压显著升高，颈静脉怒张和吸气时颈静脉扩张，称kussmaul征，常伴有肝大、腹水和下肢浮肿。由于动脉收缩压降低，舒张压变化不大而表现脉搏细弱、脉压减小，出现奇脉。
急性心包炎及时有效治疗包括原发病的病因治疗和解除心脏堵塞的对症治疗，可望获得痊愈。部份病例可遗留心肌损害或发展成缩窄性心包炎。
\n（一）一般可采用全身抗生素治疗 心包穿刺抽出脓液和心包腔内注入抗生素。穿刺方法有两种：①胸骨左旁途径；病员取半卧位，左前胸消毒铺巾，局部麻醉下于前胸左侧第四成第五肋间距胸骨2～3cm处刺入穿刺针。向后内方推进，推入时抽吸注射器，抽到脓液时停止推入，避免损伤心脏和冠状血管。抽液不宜过快，在抽液后可将适量抗生素注入心包腔内。②剑突下左肋缘下途径：病人采取半卧位，于下背部垫一薄枕，消毒铺巾。局麻下用长10cm的穿刺针，从剑突和左肋缘间的尖角处插入。针和腹壁呈45°角向上后内推进，同时吸引注射器，直至心包腔内抽出脓液。胸骨左旁途径易穿破胸膜和污染胸腔，并有刺伤冠状血管的可能，剑突下左肋缘途径方便安全。为了预防损伤心脏，可将心电图胸前导联夹在穿刺针根部，连续记录心电图，当针尖与心脏表面接触时，qrs波变为倒置，而穿刺针退出时qrs波恢复正常。
\n（二）心包腔引流术 穿刺排脓后心包腔积脓和毒血症状未见减轻或脓液稠厚，穿刺排脓困难，应采用心包切开引流术。采用胸骨左旁弧形切口，切除第4、5肋软骨后向外侧推开胸膜。切开心包前需穿刺确诊后用十字形切口切开心包膜并切除一块心包活检，吸净脓液后再用手指分离间隔的脓腔和放橡皮条引流脓液。此外也可采用剑突下心包引流术。一般引流通畅可在4～6周愈合。
\n\n
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急性心包炎几乎都是继发性的。部分病因至今不明，其中以非特异性、结核性、化脓性和风湿性心包炎较为常见。化脓性心包炎常见的致病菌为肺炎球菌、葡萄球菌、链球菌感染。
急性心包炎的临床护理计划
【一般护理】
1）急性心包炎病人应卧床休息，给予氧气吸入，并保持情绪稳定，以免因增加心肌耗氧量而加重病情。休息时可采取半卧位以减轻呼吸困难；出现心包填塞的病人往往采取强迫前倾坐位，应给病人提供可趴俯的床尾小桌，并加床挡保护病人，以防坠床。
2）饮食上给予高热量、高蛋白、高维生索、易消化的半流食或软食；如有水肿，应限制钠盐摄入。
【心理护理】
1）病人气急发生后，常常精神紧张，甚至是恐惧心理，陪护人员应守护在旁，给予解释和安慰，消除不良心理因素，取得病人的配合。
2）在行心包穿刺抽液治疗前，向病人做好解释工作，通过讲解此项治疗的意义、过程、术中配合事项等，减轻恐惧不安情绪。护士可在手术中陪伴病人，给予支持、安慰。
【病情观察】
1）注意胸痛及心前区疼痛，若症状明显，应及时通知医师，按医嘱给予镇痛剂或镇静剂。注意观察疼痛的性质，疼痛发展快者一般为化脓性心包炎，慢者大都为结核性、肿瘤和非特异性；疼痛较剧烈者多为急性非特异性和化脓性心包炎。如在深吸气、咳嗽、变换体位时疼痛，系心包炎累及胸膜引起。局部可放置冰袋，减少咳嗽和变换体位以使疼痛减轻。干性纤维蛋白性心包炎，可取左侧卧位，减少胸膜摩擦，减轻疼痛。
2）密切观察呼吸、血压、脉搏、心率、面色等变化。如出现面色苍白、呼吸急促、烦躁不安、紫绀、血压下降、刺激性干咳、心动过速、脉压小、颈静脉怒张加重、静脉压持续上升等心包填塞的症状，应立即帮助病人取坐位，身躯前俯，并及时通知医师，备好心包穿刺用品，协助进行心包穿刺抽液。如不能缓解症状，应考虑心包切开引流。
心脏外面有脏层和壁层两层心包膜，如它们发生炎症改变即为心包炎，可使心脏受压而舒张受限制。心包炎可分为急性和慢性两类，慢性心包炎较严重的类型是缩窄性心包炎。
\n心包炎可以分为两类，包括急性心包炎和慢性心包炎，其发生的病因也不相同：
\n(1)急性心包炎可因感染,结缔组织异常,代谢异常,损伤,心肌梗塞或某些药物引起,或可为非特异性.
\n(2)慢性缩窄性心包炎通常为非特异性的,但几乎任何急性心包炎均可成为其原因.常见的原因为结核或其他感染,新生物,日光或声音的辐射,类风湿关节炎,创伤和心脏手术.风湿热之后极少有缩窄性心包炎.
\n临床上对本病的预防主要包括积极治疗原发病，如结核病、风湿热、败血症等。同时应加强锻炼，提高机体抵抗力。慎起居，节饮食、调理情志。
\n","barId":"1688","topicTypeId":"3","topicThemeId":"1023","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1370,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1486702961168,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1486702961160,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"b1a5ca4ddfad11e6a61c00163e04584d","isDel":0,"createAt":1484984778320,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"小海螺","password":"yiren2921","level":0,"nickName":"小海螺78","realName":null,"signName":"开心每一天","head":"http://01luntan.com/ly_img/1484985295689.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"2276635444@qq.com","address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110108","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"4724","isDel":0,"createAt":1486702891211,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","title":"如何降低患心脏病的机率","content":"
国外研究人员根据流行病学调查得出结论：标准体重、胆固醇和血压水平正常，以及适量运动和远离烟草，是降低患心脏病风险的5个重要条件。
在各项独立危险因素中，糖尿病对心脏病影响最大。67%的男性糖尿病患者会在50岁时患上心脏病，而57%的女性糖尿病患者会在70岁时患上心脏病。体重和运动也会影响心脏病的发病概率。通常，肥胖且久坐的女性，患心脏病的风险会增加3.5倍;肥胖女性如坚持规律运动，患心脏病的风险为2.5倍;体重未超重，但没有运动的女性，患心脏病的风险约为1.5倍。
研究人员指出：不论年龄多大，只要能将上述5个关键因素严格控制在标准范围之内，是完全可以避免患心脏病的。
外科手术最常用的康复方法是运动疗法，即通过运动来改善病人的精神和恢复器官的功能，下面对运动疗法及其训练做简单介绍。
心脏手术无论对病人的机体还是心理都是一种创伤和应激，这种创伤会使病人在一段时间内丧失生活能力，为帮助病人尽快恢复手术创伤，使之接近正常的良好状态，康复护理是必不可少的手段。由于康复需要有一个循序渐进的过程，病人在术后住院期间或出院后都要进行不同形式的康复护理，因此帮助病人实现康复目标，不仅需要医护人员的努力，还要有病人的配合和家属的支持与协助。康复护理的基本手段是根据病人的病情，帮助病人选择合理的康复方法，并督促病人有效地实施。外科手术最常用的康复方法是运动疗法，即通过运动来改善病人的精神和恢复器官的功能，下面对运动疗法及其训练做简单介绍。
(1)运动疗法的目的和对身体康复的影响：运动疗法的目的是改善关节活动范围，增强肌肉张力，促进血液徨，调节身体主要脏器的功能，提高情绪和日常生活能力。通过运动可以改善脑血流量，增加心律和心排血量，增加通气量，促进机体康复。适当运动对心脏手术后病人心肺功能恢复有重要意义。
(2)运动训练的基本内容：
a 关节运动 \n关节运动原则上要以近位关节到远位关节，但由于上肢运动对胸部切口影响大，帮心脏术后病人要从下肢远端开始活动。活动时要慢慢进行，动作不宜过大，术后第二天，病情平稳可在护士指导下开始活动，活动量以不感到疲劳为度。手或下肢有输入液体时不宜做关节活动。
b 呼吸运动 \n脱离呼吸机后，为预防肺内感染和肺不张，要进行适当的呼吸运动和咯痰训练。运动方法为深呼吸、嗽瓶、吹气球、呼吸训练器及软垫按压刀口协助咯痰等，有条件还可穿弹性背心，保护刀口。
c 生活能力训练 \n术后病情平稳，病人可在床上坐起，自己练习吃饭、喝水、洗脸、刷牙、穿脱衣裤等运动。恢复期病人下地步行活动，步行训练的顺序是：坐位--》站位--》扶床移动--》独立移步--》室内走动。病人出院后还应继续做上述动作。运动幅度和运动量可逐渐增加，如步行训练可由慢步街逐步过渡到上楼梯，快步行走，小儿心脏手术刀口愈合后，还要练习扩臂运动，防止“鸡胸”。
(3)不宜做运动的病人：包括严重心肺功能不全;术后发烧、贫血;安静时心率超过100次/分;训练时出现呼吸困难、晕眩、胸痛或紫绀;运动时心率超过135-140次/分。45岁以上心率超过120次/分，应引起注意。
单心室容易与哪些疾病混淆？
单心室诊断并不困难，而手术前病理解剖学诊断则不很容易。因此，在鉴别诊断上主要集中在对不同类型单心室的鉴别上。anderson将单心室分为三种类型：
①左心室型：以左心室形态主，右心室仅为一小残腔;
②右心室型：以右心室形态为主，左心室仅为残腔，临床上很少见;
③中间型：左、右心室形态并存而室间隔缺如。
根据心房是否正位、有否大动脉错位、肺动脉狭窄等又分成若干亚型。单心室常合并其他心内畸形。临床上以左心室型单心室最多见，约占80%。左心室型单心室常伴有左侧大动脉错位，右侧房室瓣为二尖瓣，左侧房室瓣为三尖瓣，部分患者在左、右房室瓣之间可见一条肉柱。如肺动脉起源于右侧房室瓣前上方，其解剖结构最利于做分隔手术。左心室型单心室如伴有右侧大动脉错位，常合并肺动脉狭窄，不易做分隔手术。
单心室可以并发哪些疾病？
单心室合并其他先天性心脏畸形，以肺动脉瓣狭窄和房间隔缺损最为常见，分别见于51%和27%的病人；也可合并冠状动脉畸形；传导系统位置异常且多变，在有一个出口腔室和那些房-室和心室-大动脉相互关系不一致（左袢）的病人，房室结呈异常前位，在无出口腔室的病人，房室结的位置捉摸不定，可呈后位、侧位或前位；当出口腔室为左向前位时，总传导束环绕肺动脉瓣下流出道的前方，贴近肺动脉瓣附着处；若出口腔室呈右向和前位，则传导束位于肺动脉瓣环的下后方；在无出口腔室者，传导束位于心室体的后方。
单心室应该如何治疗？这是许多患者家人想要了解的一个问题，单心室或称总心室或单室心是一种较少见的先天性畸形。其发病率在活婴中约为1∶6500，约占先天性心脏病的1.5 单心室的症状，那么下面我们就来给大家介绍一下该疾病如何治疗，一起来看看吧！
\n如何治疗单心室？
\n心室排外手术治疗单心室
\n（fontan手术）使肺循环与心室直接从心房进入肺动脉（缝闭该侧房室瓣孔和肺动脉根部），而遗下的单心室专供体循环使用。mayo临床医院截至1983年，为128例单心室病人做了fontan术，手术死亡率25%，后50例死亡率降至14%。心室与主动脉之间血流通道有狭窄者，fontan手术的危险性特别高。
\n姑息性手术治疗单心室
\n以增加（体-肺动脉分流术）或减少（肺动脉环束术）肺血流量改善其症状。但姑息性手术亦有其缺点，如体-肺动脉分流术后肺动脉常扭曲变形，使日后纠治术时发生困难；肺血流增加太多会因增加心室容量负荷而促成心衰；上腔静脉-肺动脉吻合术（glenn手术）不增加心室容量负荷，但有时晚期会发生同侧肺动脉脉瘘；肺动脉束带向远侧移位会造成肺动脉扭曲等。moodie等分析姑息手术用以治疗单心室的效果，发现不管是为增加或减少肺血流量而手术，30%a型和75%c型单心室死于确诊后10年内，因此姑息性手术既有用处又有不足或不尽满意之处。
\n心室分隔术治疗单心室
\n以大块人造纤维织物，将心室腔一隔为二，各接受一侧房室瓣的血液，并分别供应肺动脉和主动脉。手术复杂而困难虽经不断改进操作技术，但早期和晚期死亡率仍不能令人满意。mayo临床医院feldt曾报道45例，其早期和晚期死亡率分别达47%及18%，存活的16例中12例情况较好，4例疗效不佳。11例为左向前位主动脉瓣下流出道腔室、术前无充血性心衰、先前未行姑息手术、且术前无明显紫绀者，其手术存活率达82%，综合其他报道的资料亦说明，分隔术应限用于具有左向前位的主动脉瓣下输出腔室（a-ⅲ型）、正常房室瓣、心室输出部无阻塞病变、先前未施行过姑息性手术以及术前无充血性心衰及明显紫绀者。
\n以上就是关于单心室应该如何治疗的介绍，希望以上内容能对您有所帮助，最后祝您及家人身体健康！
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法国专家在日前闭幕的第十七届法国心脏病协会大会上强调，心脏病防治工作的重心在于预防，尤其应重视戒烟、减肥、运动和忌口四大预防措施。
专家们指出，通过改变生活规律、定期检查和药物配合，80%的心肌梗死是完全可以预防或大幅减轻病症的。临床经验证明，预防心脏病的第一条措施是彻底戒烟;其次是控制体重，尤其是减少腹部脂肪;第三是加强锻炼，如每天至少快走30分钟，坚持爬楼不乘电梯，以及尽量减少开车和乘车等;第四，注意改善饮食，不吃十分饱，不吃过多的高油脂食品等。
他们强调说，心脏病有很大的遗传性和复发性，因此，有心脏病家族史的人和曾经心脏病发作的人更应加强预防。然而，法国41%有心脏病家族史的人在亲属发病后仍然没有改变不健康的生活习惯，40%曾经患过心脏病的患者依然故我。此外，45%的法国人从来没有体育锻炼的习惯，这也是法国心脏病发病率和死亡率居高不下的重要原因。
专家们认为，除心脏病高危人群自身必须加强预防外，医学界也应积极行动，如对有家族史以及患有高血糖、高血脂或高血压的人群加强定期检查，以及帮助和提醒他们采取必要的医学和健康保健措施等。
【临床表现】 \n
症状和体征与巨大的房间隔缺损和房室管畸形相似。常见哭吵时气急、紫绀。早期出现心力衰竭，逐渐出现紫绀和杵状指、趾，在肺动脉瓣区有喷射性杂音，第2音亢进固定性分裂，心尖区有二尖瓣关闭不全的收缩期杂音。 \n
【辅助检查】
胸片：显示肺血管影纹增多，心影扩大，以右房、右室扩大为主，肺动脉段隆起。 \n
心电图检查：轴心左偏，常出现房室交界性节律，大致与房室管畸形相似。 \n
切面切超声心动图检查：左、右心房之间，房间隔回声反射消失，四腔切面象上正常情况下，由房间隔、室间隔、二尖瓣、三尖瓣形成的十字形回声反射改变为t字形回声反射。 \n
右心导管检查：导管极易从右心房进入左心房或导管径路与房室管畸形相似。实际上单心房为混合血液，故心房、心室和两根大动脉的血氧饱和度大致相似。 \n
选择性心房造影：可显示单心房，左心室造影可显示二尖瓣返流。
【鉴别诊断】 \n
单心房需与室间隔缺损、完全性肺静脉异常回流、完全性大动脉错位、三尖瓣闭锁和完全性房室管畸形等鉴别。单心房临床症状和体征类似大型房间隔缺损或房室管畸形，但症状出现早而重，有紫绀但肺血流量增多，心房水平有大量左向右分流但无明显肺动脉高压的证据为其特征。
《美国高血压杂志》上的一份研究报道提出，青少年时期血压升高或者从青少年到成年时期血压水平相对升高可能会增加其成年后患动脉粥样硬化的危险。
研究人员指出，这一结果进一步证实，患心血管疾病危害的增加始于青少年时期。经过计算，青少年时期血压每超过正常水平一个标准差，其成年后患心脏病的危险就会增加1.9%。
冠心病的病因是动脉粥样硬化，而这一发展始于儿童时代，经过一个漫长的无症状的潜伏期，至成年时方出现明显的临床表现，这些病变在早期是可逆的，进入晚期后则变成不可逆的变化。因此，预防冠心病的最佳时期，应是在儿童时期。预防的重点：
1、合理膳食，避免肥胖
对于不断生长发育的儿童，应该在供给足够的蛋白质、维生素、矿物质、纤维素及所需热量的基础上，避免过多的脂肪和甜食。在膳食的安排上，要提倡多吃植物油，少吃动物油，口味清淡，荤素同食，蔬菜、水果缺一不可。
2、经常锻炼，增强体质
让儿童每天都有一定量的运动，体格锻炼和体育运动，这样不仅可以增强消耗，调整身体的能力平衡，防止肥胖，而且可以促进心血管功能，增强心肌收缩力，降低血管紧张度，使冠状动脉扩张，血压下降，也可以使三酰甘油及血液粘稠度下降。这些对预防冠心病及高血压都十分有利。
3、预防高血压的发生
因为血压升高是冠心病发病的独立危害因素，高血压和冠心病的关系是因果关系，所以在儿童时期就应该预防高血压，尤其是那些家庭中有高血压病人的孩子。要对中小学生定期测量血压，若血压处于百分位上限，则应给予卫生保健方面的指导，包括减轻体重，增加体力活动，改善膳食结构，减少食盐摄入量。
4、防止吸烟的危害
目前，儿童被动吸烟的情况十分普遍，更令人不安的是一些学生模仿大人，偷偷地吸烟，成为新一代烟民。为此，我们必须加强卫生宣传，并采取一些必要的措施，以免下一代受到吸烟的危害。
先天性心脏病小儿居家须注意：
※ \n安排合理的生活制度，既要增强锻炼、提高机体的抵抗力，又要适当休息，避免劳累过度，如果患儿能够胜任，应尽量和正常儿童一起生活和学习，但应防止剧烈活动，同时教育孩子对治疗疾病抱有信心，减少悲观恐惧心理。
※ \n给予高蛋白、高热量、富含维生素的饮食，以增强体质，进食避免过饱，有时喂养患儿比较困难，吸奶时容易气促乏力而停止吮吸，且易呕吐和大量出汗，故喂奶时可用滴管滴入，以减轻患儿体力消耗。
※ \n室内空气要流通，冬天应定时打开窗户，以加强空气对流，有持续青紫的患儿，应避免室内温度过高，导致患儿出汗、脱水。
※ \n青紫型心脏病患儿须给以足够的饮水量，以免脱水导致血栓形成。
※ 保持大便通畅。青紫型患儿注意大便时勿太用力，以免加重心脏负担。
※ \n先天性心脏病患儿禁止大量输液，如必须输液时，滴液速度须缓慢，以防加重心脏负担，导致心力衰竭。
※ \n平时心脏功能和活动耐力都较好的患儿，应当按时接受预防接种，并在接种后多观察全身和局部反应，以便及时处理。
※ \n先天性心脏病的患儿体质弱，易感染疾病，尤以呼吸道疾病为多见，且容易并发心力衰竭，故应仔细护理，随着季节的变换及时增减衣服，如果家中有上呼道感染疾病出现，应采取隔离措施，平时尽量少带患儿去公共场所，在传染病好发季节尤其要及早采取预防措施。
※ \n避免患儿情绪激动，尽量不使患儿哭闹，减少不必要的刺激，以免加重心脏负担。
※ \n有时患儿在行走或玩耍后会主动蹲下片刻，那是因为蹲踞后可使缺氧症状得到缓解，此时切不可强行将患儿拉起。
※ \n一旦发现患儿有气急烦躁、心率过快、呼吸困难等症状，可能发生心力衰竭时，应及时送医院就诊。
\n
接受事实，接受专业治疗
如果孩子已经罹患先天性心脏病，那么请父母接受已经发生的事实，不要再互相指责和埋怨，这对宝宝的病情毫无益处，大家应该互相勉励，积极与医生配合，让小宝宝得到最好的、最合适的治疗和护理。
据相关资料统计，先天性心脏病如今已成为5岁以下儿童的第一死亡原因。怀孕后的头三个月是胎儿心脏内结构发育成形的关键时期，此时不能有任何干扰，如果在发育过程中任何原因导致心内结构发育出现停顿、混乱或出生后应该退化的组织未能退化即可形成心脏内出现缺损、各部分连接异常、发育不良、闭锁或出现异常通道，即为先天性心脏病。
\n
由于先天性心脏病缺乏有效的预防方法，加上没有经过治疗的先天性心脏病患儿到一岁时有一半死亡，到两岁时有2／3死亡。因此，早发现、早诊断、早治疗是减少该病自然死亡率的关键。
婴儿常常会做出一些令人费解的行为，如不停地大哭、莫名其妙地躁动不安等，而且很难被“安抚”下来。专家称，不要以为这是婴儿“不懂事”，这些行为预示着他们的心脏可能有问题。平时家长发现孩子有以下表现时就应警惕患有先心病：
经常感冒，反复出现支气管炎、肺炎。喂奶困难或婴儿拒食、呛咳，常出现吃吃停停、呼吸急促、面色苍白、憋气等。皮肤持续地出现紫绀，在鼻尖、口唇、指趾、甲床最明显。能走路的孩子，在行走或玩耍时常会主动蹲下片刻。较年长的小儿手指及脚趾末节粗大、颜色变暗。儿童诉说易疲乏，体力较差，平素多汗、口周发青、咯血。发育不正常，表现为瘦弱、营养不良、发育迟缓等。孩子出现胸痛、晕厥。
心肌炎本来是可防的，但因为有的人忽视了心肌炎，到最后往往的影响了心脏功能，甚至危及生命。因此，了解心肌炎防治知识，能够有效降低疾病发生。下面是心血管内科副主任医师徐琳，给我们详细的讲述了心肌炎的分期，以及与风湿性心脏炎、克山病的辨别方法。
\n心肌炎分急性期、恢复期和慢性期
\n“目前，心肌炎在临床上已经不采用急性期和亚急性期这种分法。”徐琳介绍，三个月内是急性期，三个月至一年是恢复期，一年后还没有好，就称为慢性期。实际上急性期和亚急性期很难去区分，症状比较相似，我们现在的说法是急性期、恢复期和慢性期。之所以分期是因为病程上的治疗，真正的临床工作中很难去区分清楚，分期的目的就是为了协助治疗。
\n心肌炎可引起心衰 要及时就诊
\n徐琳表示，心肌炎并发症是让医生最头疼的，本来心肌炎是可以自愈，但是有些患者的发病期比较急，没有及时就诊会导致恶性心律失常、心力衰竭、心功能不全，病毒在心肌留下了疤痕，留下的疤痕我们就称为心肌炎的后遗症，这些都称之为心肌炎的并发症。通常心肌炎是不会发生并发症的，只有从急性期慢慢转变到慢性期，一直没有自愈，这时候并发症就出现。有的病人可能几年出现，有的病人可能二三十年才出现，时间跨度是很大的。
\n心肌炎容易跟风湿性心脏炎、克山病混淆
\n“克山病是一种地方病，而风湿性心脏炎随着生活水平的提高，这两种病已经不常见，这是一个很好的信息。”徐琳说，风湿性心脏炎是一个广义的概念，乙型溶血性链球菌感染了以后会引起一系列感染、变态反应，还有免疫性疾病等一系列疾病，这种疾病会侵犯到心脏和全身。风湿性心脏炎包括心包炎、心肌炎、心内膜炎、心瓣膜炎。实际上要跟我们所说的病毒性心肌炎相区分的应该特指风湿性心肌炎，也就是风湿性心脏炎的一种。
\n那么病毒性心肌炎和风湿性心肌炎怎么区分呢？徐琳表示，一方面是发病机理不同，风湿性心肌炎主要是链球菌感染，病毒性心肌炎主要是病毒感染，克山病主要是缺硒引起的，病因是完全不同的。另一方面，从发病特点来说，它们之所以难辨是因为症状和体征非常相似，那我们可以做一些检查，如心脏超声，当看到病人心脏是弥漫性增大和心脏运动不好的时候，要考虑是病毒性心肌炎；如果是心脏瓣膜上有很多赘生物，这有可能是风湿性心肌炎。另外，做病原体分离，能够检测出病原和病毒，这是最好的，包括抗体检测。我们现在还是采取一些常规的方法来鉴别，克山病在以前黑龙江地区发现的，是一种没有原因的心脏增大，后来发现了是因为缺硒所致。但现在生活水平提高了，这种病基本上没有了，它的病理改变主要跟扩展性心肌病很相似，没有细菌病毒感染，就是间歇性心功能不全，从鉴别方面还是很好鉴别的。治疗方面是完全不一样的，风湿性心脏炎主要针对风湿热；病毒性心肌炎主要是抗病毒和保护心肌；克山病针对缺硒。
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