{"nowTime30":1785256445496,"lyBarModerator":null,"metaSearch":{"description":"　　急性化脓性心包炎是一种由化脓性细菌引起的心包急性化脓性炎症。由于抗菌素广泛应用，发病率明显降低。　　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","keywords":"急性化脓性心包炎_洞医","title":"急性化脓性心包炎_洞医","channels":null},"identificate":{"id":"0300b4bddfaf11e6a61c00163e04584d","isDel":0,"createAt":1484985344390,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","realName":"赵玉","certifiedStatus":2,"phone":"111111111111","email":"2276635444@qq.com","hospitalId":"31c19c1b453011e69d4700163e005165","departmentId":"2000","illName":"","illId":"793a72a2bb5f11e6a61c00163e04584d","cardType":1,"cardImg":"http://01luntan.com/ly_img/1484985951761.jpg","idCardImg":"","identityType":2,"stop":0,"departmentName":"儿科","hospitalName":null},"canEdit":null,"adList":[],"lyBar":{"id":"1688","isDel":0,"createAt":1483439339980,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"北京协和医院心血管外科","type":101,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":"110000","cityId":"110101","illId":null,"hospitalId":"15009","keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"description\":\"洞医为您提供:北京协和医院心外科专家、北京协和心外科电话、北京协和心外科病友的治疗经验等相关信息，让您在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"北京协和心外科_北京协和医院心外科专家_北京协和心外科电话_洞医\",\"title\":\"北京协和心外科_北京协和医院心外科专家_北京协和心外科电话_洞医\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"1546","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"急性心包炎预防","content":"<p>　　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。</p>\n<p>　　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：</p>\n<p>　　(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.</p>\n<p>　　(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.</p>\n<p>　　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。</p>\n<p>&nbsp;</p>","barId":"1688","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":"1818","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"急性心包炎的护理计划","content":"<p>　　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。</p><p>　<strong>　急性心包炎的临床护理计划</strong></p><p><strong>　　【一般护理】</strong></p><p>　　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。</p><p>　　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。</p><p>　　<strong>【心理护理】</strong></p><p>　　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。</p><p>　　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。</p><p>　<strong>　【病情观察】</strong></p><p>　　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。</p><p>　　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。</p><p><br/></p>","barId":"1688","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":5},{"id":"2085","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"缩窄性心包炎治疗效果怎么样","content":"<p><span style=\"color: #333333; font-family: 'Hiragino Sans GB', Helvetica, 'microsoft yahei', simsun, arial; font-size: 14px; line-height: 32px; background-color: #fcfcfc;\">咳嗽，胸腔积液心包积液，眼肿，腿肿，心脏憋闷。2014年12月发病，现在想治疗缩窄性心包炎，不知治疗效果怎么样，有点担心</span></p>","barId":"1688","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":"3616","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"孩子现在需要手术吗？多会手术合适呢？","content":"<p><span style=\"color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; font-size: 14px; line-height: 32px; background-color: rgb(252, 252, 252);\">孩子吃奶少，偏瘦，有时候呛奶，没有感冒，精神好。</span></p><p><span style=\"color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; font-size: 14px; line-height: 32px; background-color: rgb(252, 252, 252);\">孩子现在需要手术吗？多会手术合适呢？</span></p>","barId":"1688","topicTypeId":null,"topicThemeId":"1019","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":1},{"id":"3240","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"冠心病的前期症状 冠心病吃什么比较好","content":"<p>　　冠心病是我们大家比较熟悉的一种心脏疾病，这个病给患者的身体带来严重伤害，生活中得过冠心病的并不在少数。如果你害怕自己或者家人会得冠心病的话，那你还是掌握一些冠心病的前期症状比较好。想知道冠心病最佳治疗方法以及冠心病偏方，那就一起来看看吧。</p>\n<p>　　<strong>冠心病的前期症状</strong></p>\n<p>　　1、劳累或精神紧张时出现胸骨后或心前区闷痛，或紧缩样疼痛，并向左肩、左上臂放射，持续3-5分钟，休息后自行缓解者。</p>\n<p>　　2、体力活动时出现胸闷、心悸、气短，休息时自行缓解。</p>\n<p>　　3、饱餐、寒冷或看惊险片时出现胸痛、心悸者。</p>\n<p>　　4、冠心病的患者在夜晚睡觉枕头低的时候，则会感到胸闷憋气，因此需要高枕卧位才会感到舒适。</p>\n<p>　　5、熟睡或白天平卧时突然胸痛、心悸、呼吸困难，需立即坐起或站立方能缓解者。</p>\n<p>　　6、用力排便或者夫妻生活用力时出现心慌、胸闷、气急或胸痛不适者。</p>\n<p>　　7、冠心病的患者，在听到周围有锣鼓或者是其他噪音的时候，则是会感觉到心慌、胸闷等情况。</p>\n<p>　　8、反复出现脉搏不齐，不明原因心跳过速或过缓者。尤其是目眩，短暂晕厥。</p>\n<p>　<strong>　冠心病的常见症状</strong></p>\n<p>　　1、患者在发病初期，因受到不良刺激，如惊险、寒冷或担心时，就会出现胸痛、胸闷、心悸等症状，或是在劳累后易感到胸闷、呼吸不畅等症状，这些都是冠心病的常见症状，患者一定要引起注意。</p>\n<p>　　2、患者在进行体力劳动过后，常会出现气短、心慌、呼吸困难等症状，还可表现出胸骨的后部或者是心前区闷痛，或者是紧缩样的疼痛感，同时向左肩以及左上臂蔓延，经过几分钟的休息后，症状可自行缓解。</p>\n<p>　<strong>　冠心病吃什么好</strong></p>\n<p>　　1.山楂菊花代茶饮</p>\n<p>　　山楂12、杭菊花9克，开水沏，代茶饮。高血压病或兼高脂血、冠心病者均可常服。肝火上炎型、阴虚阳亢型高血压病亦可配用。</p>\n<p>　　2.菊槐绿茶饮</p>\n<p>　　杭菊花、槐花各3-6克，绿茶3克，开水沏，代茶饮。适应症同山楂菊花代茶饮。</p>\n<p>　　3.雪羹汤</p>\n<p>　　荸荠、海蜇头各100-200克，煮汤，每日分2-3次服。适用于高血压病而兼见痰浊表现者，临床以眩晕、头痛、胸脘满闷或有呕恶痰涎、舌苔白腻、脉弦滑为特征。</p>\n<p>&nbsp;</p>","barId":"1688","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":1},{"id":"3420","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"冠心病的发病原因 冠心病是怎么出现的","content":"<p>　冠心病这种疾病，给我们的身体造成了严重的伤害，尤其是在家庭当中，有中老年人群的时候我们就会更加的关注，那么冠心病的发病原因又是怎样的呢？冠心病它是直接地危害着我们心脏的疾病，但是对于这种疾病我们并不了解它的引起原因，所以在生活当中我们对于他发出的症状表现有都会常常混淆。今天我们就来具体了解一下冠心病的引起原因，能够去从中找出预防的措施。</p>\n<p>　　抽烟是具有很大的危害的</p>\n<p>　　冠心病在出现的时候，最典型的原因就是抽烟，所以冠心病的发病原因当中，也包括着抽烟方面的因素，因为烟草当中含有的多种致病因子，特别是有尼古丁，他会直接地引起冠状动脉出现痉挛，会直接对冠状动脉粥样硬化产生一定的作用。在抽烟的人群当中，能够出现冠心病的人群是比较高的。血压的升高，以及糖尿病或者是高血脂也都会直接的诱发冠心病的发生。</p>\n<p>　　改变生活规律预防冠心病</p>\n<p>　　冠心病给我们的心脏，带来了很大的痛苦，也会对我们的家庭造成一定的危害，所以我们还是尽快的去治疗为好，在生活中我们不要经常的去抽烟，应该改变抽烟的习惯，或者是戒掉抽烟的现象，也不要经常的吸二手烟，出现了糖尿病，这个时候要抓紧时间进行治疗，控制血糖的上升平时应该多锻炼自己的身体去控制自己的情绪，不要过度的紧张或者是焦虑，以及兴奋过度。</p>\n<p>　　对于冠心病，相信很多朋友都不陌生了，冠心病一旦发作的话，轻则心肌梗塞心绞痛，重则可能直接的影响到我们的身体健康，所以说我们必须要及早的对其预防，这样才能防止我们的健康受到威胁，</p>\n<p>　　预防冠心病一定要从平时做起，只有这样，一方面可以调节好自己的身体另一方面提高自身的抵抗能力才能够对抗一些外来病毒的入侵。同时我们平时也要注意自己的心理变化，不可以过度的劳累，必要的时候也是要定期的到医院进行检查。注意自己的身体健康，这样才是最有帮助的。</p>\n<p>&nbsp;</p>","barId":"1688","topicTypeId":null,"topicThemeId":"1015","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":1}],"pageObj":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":5,"pageNumber":0,"totalPage":0,"totalRow":0},"loginUser":null,"replies":[],"forumUserFans":null,"herfList":[],"only":"0","topic":{"id":"2640","isDel":0,"createAt":1486703087084,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","title":"急性化脓性心包炎","content":"<p>　　急性化脓性心包炎是一种由化脓性细菌引起的心包急性化脓性炎症。由于抗菌素广泛应用，发病率明显降低。</p><p>　　<strong>1.病因及致病菌</strong>：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。</p><p>　　<strong>2.病理</strong>：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。</p><p>　<strong>　3.临床表现及体征</strong>：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。</p><p>　　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。</p><p>　　<strong>4.有关诊断检查：</strong></p><p>　　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。</p><p>　　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。</p><p>　　超声心动图：心包腔内大量液体反射波。</p><p>　　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。</p><p><br/></p>","barId":"1688","topicTypeId":"1","topicThemeId":"1015","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1668,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1486703087086,"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":1486703087084,"metaSearch":null,"rn":null},"userAllInfo":{"id":null,"isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":null,"password":null,"level":0,"nickName":null,"realName":null,"signName":null,"head":null,"phone":null,"mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":0,"userType":0,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":0,"provinceId":null,"cityId":null,"userLevel":0,"modifyNameCount":0,"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},"forumUserActiveInfo":{"id":"b1ba5254dfad11e6a61c00163e04584d","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":1705892489293,"updateBy":"b1a5ca4ddfad11e6a61c00163e04584d","updateName":"小海螺","userId":"b1a5ca4ddfad11e6a61c00163e04584d","topicCount":2201,"replayCount":900,"favorteCount":0,"beFavorteCount":0,"creamCount":2,"focusCount":1,"fansCount":4,"integralCount":2357,"foodCouponCount":0,"lastLoginTime":0,"lastLoginIp":null,"downloadCount":0,"uploadCount":0},"newPass":null,"focusBar":null,"counter":null,"forumUserIdentificateDto":null},"theme":{"id":"1015","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName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