![\"心脏起搏器安装前需注意事项与术后短期的注意事项\"](\"http://01luntan.com/ly_img/uimgs/1500736854001.jpg\" "\\"心脏起搏器安装前需注意事项与术后短期的注意事项\\"")
动脉导管闭合术中大出血所致的手术死亡率，视导管壁质地、采用闭合导管的手术方式以及手术者技术的高低等而导，一般应在1%以内。导管单纯结扎术或钳闭术有术后导管再通可能，其再通率一般在1%以上，加垫结扎术后复通率低于前二者。动脉导管闭合术的远期效果，视术前有否肺血管继发性病变及其程度。在尚未发生肺血管病变之前接受手术的病人，可完全康复，寿命如常人；肺血管病变严重呈不可逆转者，术后肺血管阻力仍高，右心负荷仍重，效果较差。
","barId":"1704","topicTypeId":null,"topicThemeId":"1023","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"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":0,"metaSearch":null,"rn":5},{"id":"5436","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"心脏起搏器安装前需注意事项与术后短期的注意事项","content":"心脏起搏器安装前注意事项：
\n1、健康史：了解病人的发病情况及以往的诊治过程。
\n1）、一般资料：年龄、性别、身高、体重、发育、饮食习惯及营养状况
\n2）、家族史：家族中有无患心脏病的病人。
\n3）、既往史、药物史：有无其他疾病及药物过敏史。
\n2、患者身体状况：了解疾病的特点、类型、重要脏器的功能等，确定病人需要安装起搏器的类型。
\n1）、心脏和全身症状：如病人的心率、心律、体温情况及活动耐受情况和自理能力等。
\n2）、辅助检查：心电图、心脏多普勒检查、血常规及出凝血时间。
\n3）、心理及社会支持情况：由于起搏器价格高，患者家属对手术的支持程度、病人的心理状态，以及对术后康复知识的了解和掌握程度非常重要。
\n
心脏起搏器术后短期内注意事项：
\n1、术后24小时内绝对卧床，取平卧位或低坡卧位，禁止翻身，术后第2天可适当术侧卧位。术后1周内术侧肢体制动，并加强观察心律变化。在术后恢复期进行肢体功能锻炼时要遵循循序渐进的原则，患侧肢体避免做剧烈重复的甩手动作、大幅度地外展、上抬及患侧肩部负重、从高处往下跳。如果出现肩部肌肉抽动，可能是导线脱离，应立即到医院检查。
\n2、术后早期应保持局部敷料清洁干燥，如有敷料碰湿或脱落要及时更换。在拆线后仍要保持局部皮肤清洁，尽量避免穿过紧的内衣，若术后出现局部红肿痛，甚至皮肤溃烂，及时到医院进行处理。若同时伴有发热等全身症状，则要考虑感染的可能，及时到医院检查治疗。
\n","barId":"1704","topicTypeId":null,"topicThemeId":"1022","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"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":0,"metaSearch":null,"rn":6},{"id":"14486","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"甘油三酯偏高的危害","content":"
血清甘油三酯的正常是多少？甘油三酯偏高的危害有哪些
","barId":"1704","topicTypeId":null,"topicThemeId":"1020","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"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":0,"metaSearch":null,"rn":5},{"id":"5438","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"简单几句话让你明白心脏起搏器原理","content":"心脏起搏器原理简单的相容来说就是一个人工的“司令部”，它的主要作用就是替代心脏的起搏点，使心脏有节律地跳动起来。心脏起搏器是由电池和电路组成的脉冲发生器组成，能定时发放一定频率的脉冲电流，通过起搏电极导线传输到心房或心室肌，使局部的心肌细胞受到刺激而兴奋，兴奋通过细胞间的传导扩散传布，导致整个心房和（或）心室的收缩。心脏的电信号使它跳动。当运行时，心脏跳动加速；当睡眠时，心脏跳动减慢。如果心电系统异常，心脏跳得很慢，甚至可能完全停止。人工心脏起膊器发出有规律的电脉冲，能使心脏保持跳动。
\n![\"简单几句话让你明白心脏起搏器原理\"](\"http://01luntan.com/ly_img/uimgs/1500739398481.JPEG\" "\\"简单几句话让你明白心脏起搏器原理\\"")
早期的人工心脏起搏器的电池部分装在身体的外部，导线从体外通过静脉到达心脏。患者只能在医院内短期使用。后来，鲁内•埃尔姆奎斯特在1958年制作了一个放在体内起搏器，锌一汞电波埋在皮下。1960年，瑞典医生奥克•森宁为一位病人植入了这种起搏器。电池一直使用了2---3年才更换。在20世纪80年代，起搏器上增加了微处理器。只有在感觉需要起搏器时，病人才启动它。今天的起搏器就更复杂了，起搏器可根据血液的湿度来调节心跳。1988年，一位病人安装了一个核动力起搏器。这个起搏器使用了微量的钚，可以持续应用20年。从这心脏起搏器的发展之路就可以看出，心脏起搏器已经越来越智能，更换电池时间越来越久。
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动脉导管未闭的症状取决于导管的粗细、分流量的大小、肺血管阻力的高低、患者年龄以及 是否合并其他先天性心脏病。
\n足月患婴即使导管粗大，需出生后6～8周，待肺血管阻力下降后才出现症状。早产婴儿由于肺小动脉平滑肌较少，血管阻力较早下降，故于第一周即可有症状，往往出现气促、心动过速和急性呼吸困难等，于哺乳时更为明显，且易患感冒以及上呼吸道感染、肺炎等。
\n小儿期得到代偿，很少有自觉症状，只是发育欠佳，身材瘦小。有些儿童仅在劳累后易感到疲乏、心悸。
\n未闭导管中等大小患者一般都无症状，直至20多岁剧烈活动后才出现气急、心悸等心功能失代偿症状。
\n肺动脉高压虽然可在2岁以下出现，但明显的肺动脉高压征候大都在年龄较大才表现出头晕、气促、咯血、活动后发绀（多以下半身发绀明显）。
\n若并发亚急性心内膜炎（心脏内膜感染），则有发热、食欲不振、出汗等全身症状。心内膜炎在儿童期很少发生，而以青年期多见。
\n","barId":"1704","topicTypeId":null,"topicThemeId":"1016","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"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":0,"metaSearch":null,"rn":5},{"id":"2172","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"先天性心脏病动脉导管未闭怎么回事","content":"
每个婴儿出生时均有一个动脉导管，这是位于两个主要血管肺动脉和主动脉之间的通道。肺动脉内流着蓝色的静脉血由心脏的右侧流向肺脏。在肺内静脉血摄取氧气成为含氧的红色的动脉血。主动脉携带红色的含氧的动脉血运行到身体的其他部分。
\n动脉导管在胎儿期间是血液运行的正常通道，出生后不再需要而在几天内逐渐闭合。如果动脉导管未能闭合，就是动脉导管未闭，常见于早产儿，而在足月新生儿中少见。对于大多数患儿，动脉导管未闭的原因不明。
\n正常情况下，左侧心脏只泵血到主动脉，而右侧心脏只泵血刀肺动脉。动脉导管未闭时，部分血液由主动脉流入肺动脉。当动脉导管较粗时，分流的血液需要心脏加倍作功并导致肺充血。
\n当动脉导管较细时，可能没有明显的临床症状，而只能听到明显的杂音。但当动脉导管较粗时，患儿可能呼吸急促，婴儿可能难以喂养并发育迟缓。症状可能在出生后几周才出现。由于肺血增多而引起肺动脉压力增高，久而久之肺血管发生器质性改变。
\n对于较细的动脉导管，一般不需要治疗，通常会在出生后几个月内自行闭合。对于较粗的动脉导管，可以通过介入治疗进行封堵或通过手术进行结扎治疗。对于早产儿，可以通过药物促进动脉导管闭合，如果几周后还没有闭合，可以通过外科手术结扎。
\n对于较细的动脉导管或已经封堵或手术后的患儿，可以完全正常地参加日常活动，远期预后良好。
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1.严格控制盐的摄入，盐的主要成分是钠和氯，而钠在人体内具有“水化”组织的作用，体内的钠和氯大部分都是从尿中排出的。而血液中钠离子浓度过高会引起体内大量水分的潴留，造成患儿全身水肿、肝脏肿大、增加心脏的负担，严重的还会导致心力衰竭。同时，饮食过咸也是造成高血压的重要原因之一。所以先天性心脏病手术后的患儿的饮食一定要偏淡些，腌腊制品、咸蛋、咸鱼等含盐量过高的食品尽量不要食用。
\n2.不宜多吃巧克力等甜食。心脏手术之后，当小儿不愿意吃饭时，不少家长喜欢塞巧克力给小儿吃，以为这样可以保证营养。巧克力的主要成分是脂肪和糖，热量很高，但所含的蛋白质和脂肪的比例与小儿的正常需要量相差很大。多吃巧克力易造成小儿消化不良、大便秘结、食欲减退。同时巧克力含有咖啡因等成分，食用过多不仅会使小儿过度兴奋、影响休息，而且对小儿的大脑发育带来一定的不良影响。
\n3.不宜多吃罐装饮料和冷饮。目前市场上出售的罐装饮料品种繁多，不少饮料的成分主要是糖或糖精、香料、色素和水，营养却常不足。冷饮也是孩子们都喜欢吃的，但大手术后患儿的消化器官尚处于恢复调整阶段，这时患儿的消化功能往往较弱。过冷的食物进入胃内会刺激胃粘膜血管收缩、胃液分泌减少，影响食物在胃肠道内的消化过程；同时也会减弱消化道的杀菌能力，导致胃肠道发生感染性疾病。
\n4.不宜盲目进补。有些家长认为人参有滋补作用，于是给术后的孩子喝参汤。人参确有强心壮体、补气生津的功能，但不同的人参具有不同的性能，服用不当反会引起胃口减退、鼻子出血、烦躁不安等症状。另有一些补品对生长发育期间的孩子并不适宜。
\n最好的术后“补品”乃是天然食物。家长只要按着上述的几项原则，在孩子每天的饮食中注意荤素搭配、粗细均衡，在烹调时注意防止营养素的丧失和破坏，确保一日三餐吃饱、吃好，孩子一定会尽快恢复体力的。
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