A, rib bone fracture
Diagnose important point:1, partial swell after the wound, the Yu spot, ache, a cough, deep breathing or ache for torso to turn move aggravate.
2, the part be hollow or the Tu rise abnormal, press a pain obviously, sometimes can Men and bone wipe a sound.
3, the chest Kuo squeeze to advertise for masculine gender.
4, several bone fracture outside the pairs, the part can appear abnormal breath.
5, merger pneumothorax, hemothorax, can appear chest stuffy, spirit Cu, serious even shock.
6, check:The sufferer of pneumothorax, can have skin to descend emphysema, Men it has Nian pronunciation and suffer from side Kou to diagnose a drum sound;The sufferer of hemothorax suffer from side Kou to diagnose a muddy sound;X line it is thus clear that the circumstance of bone fracture, and the observation contain etc. of have no pneumothorax, hemothorax complications, but rib cartilage the bone fracture can’t then show.
The medicine cure:1.Relieve pain:Song Ma3 Duo :Take orally a 50~100 mgs/time, re-usable when it’s necessary;The Mao substitutes Ding:Take orally a 50~100 mgs/time, 0.2~0.4 gs/d, the skin note or quiet note a 25~100 mgs/time, 0.1~0.4 gs/d; Morphine:The skin note or takes orally a 5~10 mgs/time, 1~3 times/d.
2.Prevent°from an infection:Head Bao Mao Ding:Quiet note a 0.5~1 gs, 3~4 times/d, or quiet drop 2~6 gs/d;Vanguard Ⅴ :The muscle note or quiet note a 0.5~1 gs/time, 3~4 times/vd;The oxygen fluorine sand star:Take orally a 0.1~0.3 gs/time, 3 times/d.
3. Dispel phlegm:Chlorination An:Take orally a 0.3~0.6 gs/time, 3 times/d;The Mu is at ease:The intravenous injection 15 mgs/time slowly and soon, 2~3 times/d, child over 6 years of age together adult, the 2-6-year-old child reduces half,
Child’s 7.5 mgs/time under 2 years of age, 2 times/d.
Note:Shut to match sex single place the rib bone fracture only needs to be relieve pain and need to be stop bleeding while shutting to match many several merger guts of the rib bone fracture of sex chest, prevention infection and keep a breath way lucid etc. a processing.
Two, the lung bruise
Diagnose important point:1.Light chest pain, the chest be stuffy, annoy Cu and cough, have guts phlegm…etc.;
2.The heavy has an obvious dyspnea, deliver Gan, guts foam phlegm and once moved to soon descend with blood pressure etc..
3.Check:Listen to diagnose a lung department to contain 啰 sound, breathe a sound to die down or disappear;The X line performance is a lung the afferent veins be thick but misty, the companion has a spot form the misty shadow and(or) irregular spot slice form and big slice an actually change of the form shadow.(the pathological changes distribute not to press lung segment or the scope of lobe of lung)
The medicine cure:1.Relieve pain:Use a hard film to outside anaesthetize to relieve pain or adopt a hard film to outside wear bodkin to wear into the outside of the chest film, duct into a thin tube to infuse into 0.25% cloth a ratio card because of the 3~5 mls, 24 hours total amount not over 400 mgs.
2. Benzene Shi west Lin2 Na4:The muscle note, calms down to note or quiet drop 0.5~2 gs/time, 3~4 times/d;Head Bao Shi Lin2 Na4:Quiet note, the muscle note or quiet drop 0.5~1 gs/time, 3~4 times/d;The promise fluorine sand star:Take orally a 400 mgs/time, 2 times/d, or quiet drop 0.2 gs/time, 2 times/d.
3.Does the ground fill a rice to loosen a 1~2 mgs/kg?D, continuous 3~5 ds.
4.A Ji strong loose dragon 3 mgs/kg.d.
5.Sign an its D 50 mgs+0.9% NS45 ml, the 4 mls/h tiny pump maintenance.
Notice:Should according to breath way development and medicine of the secretion germ be quick and choose to use effectively antibiotic, antibiotics of the application canned consider choosing to use the above-mentioned antibiotics according to experience before the germ develop and medicine is quick result came out.Return because of notice 1.Keep a breath way lucid 2.The machine ventilates a treatment.3.Monitor guts, metabolize sex sour poisoned should to rectify.4.The capacity recover.5.Liver kidney function not wholes carefully use hormone.
Three, pneumothorax
Diagnose important point:1.Chest external injury or chronic lung disease history, a cough or make an effort an excesssive inducement.
2.Abrupt and violent chest pain and dyspnea or stimulative stem cough, heavy can have hair Gan and shock.
3.Sit upright breath and be short of breath, the heavy is fidgety uneasy, big sweat, purple Gan, even appear shock or obfuscation.
4.Check:Suffer from side chest Kuo full, breathe sport to die down, the language Zhan dies down or disappears and the Kou diagnoses to suffer from a side drum sound and listen to diagnose a breath sound to die down or disappear.The X line typical model performance for lung to lung door compress to present round ball form shadow, part a deeply bright degree increment, the air come together of the position have no lung line, a great deal of pneumothorax can make the heart, windpipe move toward the Jian side.
The medicine cure:1.Take orally to cough a necessarily pure 25~50 mgs/time or can stay because of the 0.03~0.06 gs/time, 3 times/d.
2.The penicillin is 1,600,000~2,400,000 units/ per time, intravenous injection after using a 20 mlNS dilution, 2 times/d.
Note:In bar of greatly be constipated knot, can give slow Xie, lead a slice such as the smooth bowel fruit, numb Ren pill etc..
Four, hemothorax
Diagnose important point:1.Medium quantity and a great deal of hemothorax can have a quickly weak pulse, blood pressure to descend, spirit Cu etc..
2.The rib asks Xi full, the windpipe moves toward the Jian side and the Kou diagnoses to present a muddy sound and the heart boundary moves toward Jian side and breathe a sound to die down or disappear.
3.Check:The X line shows to harm the side chest film chamber to have a big slice to accumulate liquid shadow and the Zong separates to move toward the Jian side;Merge pneumothorax then show liquid flat surface.The chest wears to stab and can draw blood a liquid.Hemothorax appeared when hemothorax erupt infection hot and cold war, perspire, the blood cell counted to increase Gao.
The medicine cure: 1.The anti- infect:Ammonia Xia west wood:Quiet note 2~4 grams/d, divide 2~4 times;Head Bao Shi Lin2 Na4:Quiet note, the muscle note or quiet drop 0.5~1 gs, 3~4 times/d;The oxygen fluorine sand star:Take orally or quiet drop 0.3~0.4 gs/time, 2 times/d.
2.The blood of Cu Ning:The vitamin K1:The muscle note or quiet note a 10 mgs/time, 1~2 times/d;Stop bleeding quick:Quiet note or the muscle note a 0.25~0.5 gs, 4~6 hs/time;Stop bleeding Fang sour:Quiet note or quiet drop 0.1~0.6 gs/time.
3.Can arouse Mao(100,000 us) or streptococci to take off the oxygen pit sugar nucleic acid Mao(2.50,000 us) at the chest film chamber infusion chain to concretion hemothorax etc. fiber egg white fuse Mao, but medicine vice- reaction big, the price is expensive and curative effect’s owe satisfaction has been less applied now.
Note:Appear following advertise for elephant to then hint for carry on sex hemothorax:The ① vein Bo increases gradually quickly and the blood pressure continuously descends.② After transfuse blood repairing a liquid, blood pressure not rally or go up to quickly descend again behind.The ② hemoglobin, red cell count with red cell press to accumulate repeated measurement, present to continue to descend.The ④ chest film chamber wears to stab to take out not to bleed a liquid because of the blood concretion, but X line the check show that the chest film chamber shadow continues to enlarge.The ⑤ shut type chest film chamber after lead flow lead to bleed quantity keep on 3 hour, per hour over 200 mls.
Five:Nong chest
Diagnose important point:1.hot don’t back, dyspnea, a cough, chest pain, can companion malnutrition with anemic.Accumulate amount of Nong many hour the windpipe, Zong separate and heart point pulsate to move toward the Jian side, the side rib of the disease be full, breathe sport to die down and the language Zhan turn down.
2.check:The Kou diagnoses a big slice a muddy sound and the Kou diagnoses chest upper part to present a drum sound while having Nong pneumothorax;White cell total amount and neutral grain cell go up and have poisoned grain;The chest wears to stab to draw out a Nong liquid and can confirm;The X line shows chest to present a big slice an even dark shadow and the Zong separates to move toward Jian side while in great quantities accumulating Nong.Nong pneumothorax it is thus clear that annoy liquid flat surface.Wrap up the sex Nong chest is circular or egg circular shadow, don’t change with the body.
The medicine cure:1.Greatly parts of hospitals outside infect:Use penicillin G, the light disease is each 3,200,000 us/dses and divide 4 times quiet note;The advanced case 10,000,000~20,000,000 us/d divide quiet drop 4 times.
2.Infection inside the hospital and parts of hospitals are outside taken bad:Benzene Shi west wood(lately green Ⅱ )0.5~2.0 gs, the muscle note, calms down to note everyday or quiet drop 3~4 times, or the chlorine Shi west wood’s 1 g, every 4~6 hours once;Bear a medicine to the penicillin of can use a the Bao Shi Mao or head Bao Mao Fen, the 4~8 g vein drop notes everyday;Also bearing the gold grape of medicine to the AN oxygen west wood can use everyday of vancomycin the 1-2 g vein drop to note.
3.Erupt a film inside the Nong chest, meningitis, heart burning and when the kidney, brain, myocardial transfer sex abscess, can use penicillin 10,000,000~30,000,000 units/d, divide 4~6 times quiet drop.
Note:1.Impatient Nong chest according to the Nong liquid germ development and the medicine quick experiment to choose to use effectively antibiotic, support to disease with other assistance medicine treatment. 2.Chronic Nong chest according to clinical and the medicine be quick to experiment to choose to use effectively antibiotic, the Shu strengthens whole body support treatment behind before the Shu.(include lately medicine especially)
Six, chest wall tubercle
Diagnose important point:1.the chest wall have no painful sex abscess, only performance partial chest wall lump.
2.chest wall Dou way, long don’t more cure, Nong liquid inside the Dou way is turbid to have no bad smell and the proud flesh organizes pale dropsy.
3.check:X line it is thus clear that lung and chest film pathological changes, sometimes it is thus clear that rib or breastbone bone substance break;The abscess wears to stab, can draw out white at the Lao kind Nong liquid;Tu2 Pian4 and germ develop it is thus clear that tubercle rod bacteria;Dou way or proud flesh organization cut off a pathology and can discover a tubercle pathological changes.
The medicine cure:1.Chain mildewed vegetable:The muscle note, to light disease 1.0 gs/time, every week 2~3 times;To the advanced case 0.75~1.0 gs/d, divide 2 times;The child 20~40 mgs/(kg.d), at most is not over the 1.0 gs/d.
2.Sulfuric acid card that mildewed plain muscle notes a 0.1 gs 2~3 times/d, the child 7~8 mgs/(kg.d), divide three muscles to note, or quiet drop 0.1~0.15 gs, 2 times/d.
3.Different smoke Pian 5~8 mgs/(kg.d) etc..
The sort treats a distance for 3~6 months
Seven, chest film skin lump
Diagnose important point:1.The most have long-term asbestos dust contact history;Can produce while canning have no obvious symptom over a long period of time, being tumor to enlarge unwell inside chest, a cough etc. symptom, the malignant skin lump can express a chest pain, spirit short, emaciated, a cough, tired etc..
2.Check:Suffer from side chest Kou to present muddy actually change, breathe a sound to die down disappearance, the Zong separates to move and breathe sport to die down etc.;The edge clearer spheroid or the oval swollen thing shadow X line shows to limit a skin lump to show on the chest slice that the density is even, , relate to with chest film close also become obtuse-angled;The Mi spreads a skin lump and can show that the chest film is extensively irregular to increase thick or the knot stanza shadow Tu to lung wild, 75% patient’s companions have chest to accumulate a liquid;The CT shows to limit sex, the skin lump often presents hemisphere form and flat even form lump, edge clear, the Mi spreads a type to often present extensive asymmetry to increase thick or knot stanza;Diagnose sex chest wears to stab to live check and can get male diagnosis.
The medicine cure:1.Town pain:The Lu settle:Take orally a 60~120 mgs/time, 1~4 times/d, or the muscle note a 60~90 mgs/time;Eliminate inflammation a pain:Take orally to take a 25 mgs/time, 2~3 times/d, rice or the after meal immediately take;The Du cold D:Take orally a 50~100 mgs/time(measure for the 150 mgs/time very much, 600 mgs/d), or subcutaneous injection or muscle note a 25~100 mgs/time(measure for the 150 mgs/time very much, 600 mgs/d) and 2 times use medicine partition should not little in 4 hour.
2.Chemotherapy: The Pei beautiful song fills a sodium(Alimta), 500 mgs/m 2, the quiet drop is over 10 minutes;Agreeable platinum 75 mgs/m 2, 30 minutes after the Alimta drop note end, the beginning drop note and time is over 2 hours.It is a periods for 21 days.
Note:According to the clinical performance, the Ⅰ expects a skin type a malignant chest film skin lump probably exist over a long period of time, past the suggestion makes to cure for good the sex chest film lung resection for these patients, to the Ⅱ , Ⅲ and the Ⅳ expect ascend the case of skin type and other pathologic types, regardless cure with incurable, whether adoption cures for good sex or appeasement surgical operation and uses a chemotherapy and puts to treat curative effect or not, treatment empress of existence the curve be basic homology, it equally exists time as 18 months and about 10% cases once lived for 3 years.
Eight, non- cellule lung cancer
Diagnose important point:1.Breath way symptom:A cough, blood phlegm, chest pain, annoy short, have fever.
2.Later period symptom:Such as emaciated, tired, the weight ease, lymphoid knot swollen big, swallow difficulty, top chamber vein comprehensive advertise for, Horner comprehensive advertise for, Pancoast(the lung top ditch lump).
3.Lung outward appearance now:Male breast hair Huang, the Chu form point and the muscle has no dint etc..
4.Check:The chest slice expresses to advertise for or jam to advertise for for the tumor or chest water;CT, MRI:Can discover concealment diameter<the pathological changes with 3 cms, explicit pathological changes scope;Bronchus mirror:The lung cancer really diagnoses means, can observe a second segment tumor part with above bronchus and scope;Live the check needle absorb and phlegm check:The lymphoid knot, lung organization lives check pathology check and can confirm and the chest water cytology or phlegm cytology check can also help diagnosis; The CEA, NSE can go up.
The medicine cure:A glimmer of chemotherapy:1. Lose to note the yew Chun(Tai vegetable)175~225 mgs/m 2 lose to note a card platinum AUC later on over 3 hours=6 repeat every 3 weeks over 30~60 minutes, 6 total periods.2. Lose to note many west yew Chun(the Tai plain emperor)75 mgs/ms 2 lose to note a card platinum AUC later on over an hour=6 repeat every 3 weeks over 30~60 minutes, 6 total periods.3. Lose to note many west yew Chun(the Tai plain emperor)75 mgs/ms 2 lose to note an agreeable platinum 75 mgs/m later on over an hour 2 repeat every 3 weeks over 2 hours, 6 total periods.4.Lose to note an agreeable platinum 60~100 mgs/m on the 1st day 2 over 2 hours, the 2nd loses to note the 1000 mgs/m of the Ji west his strand(the key choose) with the 8th day 2 repeat every 3 weeks over 30 minutes, 6 total periods.5.Lose to note a card platinum AUC on the 1st day=6 over 30~60 minutes, the 2nd loses to note the 1000~1200 mgs/m of the Ji west his strand with the 8th day 2 repeat every 3 weeks over 30 minutes, 6 total periods.6.The 1st with 8 talents don’t lose to note the 800~1000 mgs/m of the Ji west his strand 2 over 30 minutes and promise Wei originally 25~30 mgs/m 2 lose to note over 10 minutes, repeat every 3 weeks.
Two lines cure:1. Lose to note many west yew Chun(the Tai plain emperor)75 mgs/ms 2 repeat every 3 weeks over an hour.2.The Ji doesn’t substitute Ni(easy Rui sand) to take orally a 250 mgs/d.
Nine, cellule lung cancer
Diagnose important point:1. Symptom:The cellule lung cancer is 1 to fill the air sex disease, symptom perhaps with physical volume inside the chest greatly relevant, or have something to do with distance transfer;A cough and dyspnea are the most familiar.
2.The outside of the tumor is comprehensive to advertise for:May have a low sodium blood disease, Cushing comprehensive advertise for, the Lambert-Eaton muscle have no dint comprehensive advertise for etc..
3.Check:The E.M.G. can show that the high Pin stimulate by characteristic next of Gao level of the muscle movable electric voltage.The diagnosis of the typical model is lived the histology of check by the fiber bronchus and Be worn to stab by skin and wear to stab through the bronchus thin needle of cytology to certain.
The medicine cure:A glimmer of chemotherapy:1.Lose to note a card platinum AUC on the 1st day=6 over 30~60 minutes, the 1st goes to the 3rd day to lose to note foot a leaf a B Mao 100 mgs/m 2 repeat every 3 weeks over 4 hours.2. Lose to note an agreeable platinum 60~100 mgs/m on the 1st day 2 over 2 hours, the 1st goes to the 3rd day to lose to note foot a leaf a B Mao 80~120 mgs/m 2 repeat every 3 weeks over 4 hours.3. Lose to note an agreeable platinum 60 mgs/m on the 1st day 2 over 2 hours, the 1st with the 8th day lose to note Yi to sign substitute the Kang 60 mgs/m 2 repeat every 3 weeks over 90 minutes.
Two lines cure:1. Lose to note Tuo Pu for the Kang 1.5 mgs/m 2 over connect to use 5 days for 30 minutes, repeat every 3 weeks.2. The 1st to the 4th talentses don’t lose to note to rely on the lake Mao 25 mgs/m 2, different 1200 mgs/m of the wreath Lin Mao An 2(need the beautiful Si Na to give relief to!), Agreeable the platinum 20 mgs/m 2, repeat every 3 weeks.
Note:The cellule lung cancer incline toward at central, close to lung door and Zong to separate.In the WHO 1999 the classification the system, the definition of cellule lung cancer is:The malignant tumor of a kind of top skin, from lack the cellule of afterbirth syrup to constitute, not explicit cell boundary, the tiny particle form dyes quality and lack or check Ren not obvious.The cancer cell is a circular of and be like oats, or spindle form of, the pit models obviously, there is silk abruption recording number Gao.
Ten, oesophagus cancer
Diagnose important point:1.swallowed food Geng to choke feeling in early days, after the breastbone pinprick kind ache or burn bright feeling;After its performance for carry on sex of swallow difficulty.
2.the check-up can be emaciated, or left lock the top of the bone lymphoid the knot be greatly swollen.
3.check:X line it is thus clear that the oesophagus glues the film wrinkly Bi to split, limit sex stiff, the defection and damage of Chong Ying or Xian shadow, the later period can have narrow oesophagus chamber or Geng Zu;Taking net air sac oesophagus to shed off a cell check can discover cancer cell;The oesophagus mirror can discover a pathological changes, and commendable live an organization check.
The medicine cure:1.Lose to note an agreeable platinum 75~100 mgs/m on the 1st day 2, the 1st goes to lose to note in a row on the 4th day 5-the Fu1000 mgs/ms 2, repeat every 3~4 weeks.
2. CBV project:Lose to note an agreeable platinum 120 mgs/m on the 1st day 2, lose to note the mildewed of Bo Lai plain 10 mgs/m on the 3rd day 2 with the 3rd go to lose to note the mildewed of Bo Lai plain 10 mgs/m in a row on the 6th day 2, the 1st, the 8th, the 15th, on the 22th day lose to note long spring ground bitter 3 mgs/m 2, repeat every 4 weeks.
3. ECF project:Lose to note for 3 hours on the 1st day, form the mildewed plain 50 mgs/m 2 amiable platinum 60 mgs/ms 2, lose to note continuously for 21 days 5-the Fu 200 mgs/m 2, repeat every 3 weeks.
4. PCF project:Lose to note the Tai plain 175 mgs/m in a row for the 1st day 3 hours 2, the 1st to the 4th or lose to note an agreeable platinum 15~20 mgs/m on the 5th day 2, the 1st to the 4th or lose to note in a row on the 5th day 5-the Fu750~1000 mgs/ms 2, repeat every 4 weeks.
Note:Generally to compare earlier period an oesophagus cancer proper adoption surgical operation treatment;To compare a later period pathological changes, and Be located on medium, last and young and higher or have the surgical operation taboo the certificate, then with project treatment is good.
11, the Ben door lose an idle disease
Diagnose important point: 1, swallow a difficulty, anti- food, chest pain, breastbone after satisfied bulge unwell, have heavy feeling or jam feeling, can project to the neck or the arms, heavy hour the companion has been already vomit, the later period can appear to cough such as the stem, spirit nasty, hair Gan, E negative, hoarse etc. oppress symptom.
2, check:X line barium meal it is thus clear that oesophagus extension also liquid flat surface, next carry to present a beak form, appear a negative peristalsis;Stomach mirror it is thus clear that the oesophagus extend, food inside the oesophagus remain the bottom of the oesophagus to carry to keep on a close, but still can smoothly insert stomach;The oesophagus measures to press it is thus clear that the LES pressure go up.
The medicine cure:The ① nitric acid glycerin slice 0.6 mgs, the first 15 minute of meal the bottom of the tongue contains, 3 times/d;Or the nitric acid different mountain pear ester, single nitric acid different mountain pear Chun ester;
The ② takes orally nitric benzene ground an even 10 mgs, 3 times/d;
The ③ has obvious food Zhu to stay, can the muscle note or quiet note the 10~20 mgs/time of the D bromine east Lang Dang alkali, or use give an article etc..
12, the oesophagus split bore Shan
Diagnose important point:1.Many part ache.
2.It is anti- to flow symptom and the symptom of Geng Zu.
3.Check:The Ｘ line barium meal it is thus clear that parts of stomach chambers are located on the Ge;Inside mirror check it is thus clear that the dentation is on-line to move, the oesophagus shorten and putting a mirror not to arrive 40 ｃｍs can immediately see the stomach gluing a film.The oesophagus is next, the Ben door, the stomach body small curved side have swollen Chong blood, ulcerate or the scar formation narrow etc..
The medicine cure:1.The stomach replies Anne:Take orally a 5~10 mgs/time, 3 times/d, the rice take(every time of child 1~2.5 mgs divide 3s) the first 30 minutes or the muscle note a 10~20 mgs/time;Everyday amount of thousand grams of generally each weights should not over 0.5 ｍｇs, otherwise easily cause an awl body to outside fasten reaction.
2.D Lin:Take orally a 10 mgs, 3 times/d, the meal takes the first 30 minutes.
3. The west sand compares benefit:Take orally a 5~10 mgs, 3 times/d.
4. The hydrochloric acid relies on ratio benefit:(the Rui reply Lin)Take a 50 mgs before the rice, 3 times/d, .
13, congenital heart attack
Diagnose important point:The ① suffers from a son growth growth and can compare to fall behind with age son, and easily suffer from a breath way an infection.
The ② has or has no green purple.
The ③ most can be correspond part to hear the heart miscellaneous sound, serious can the companion has before the chest area tremor.
④ Among them method Luo surname the child of four allied diseases be pleased to squat down Ju, and it is thus clear that the Chu form point(toe).
The medicine cure:1.Strong heart:① Ground Gao Xin:The adult takes orally a 0.25 mgs/d;The child 0.06~0.08 mgs/kg under 2 years of age, 0.04~0.06 mgs/kg over 2 years of age, tasty or quiet note;② West ground orchid:Quiet note, 0.2~0.4 mgs/time, 1~2 times/d.
2.The benefit wet:The ① soon wets:The adult takes orally 20 mgs/d or 40 mgs/following day(need can add to the 120 mgs/d), or the muscle note or quiet note a 20~40 mgs/time;The child takes orally a 1~2 mgs/kg, can add quantity when it’s necessary;The ② hydrogen chlorine Mao Mao:The adult takes orally a 25~100 mgs/d and divide to take 1~3 times;(can add to the 100~200 mgs/d when it’s necessary, divide to take 2~3 times)The child takes orally a 2 mgs/(kg.d), divide 2 times to the medicine;The ③ ester inside the Luo:The adult takes orally a 20~40 mgs/time, 3 times/d.
3.Expand a tube:The card gives Pu benefit:The adult takes orally a 12.5 mgs/time, 2~3 times/d;(can increase to the 50 mgs/time when it’s necessary, 2~3 times/d)The child takes orally to start a 0.3 mgs/kg, 3 times/the d increases a 0.3 mgs/kg every 8~24 hour when it’s necessary, is not over the 6 mgs/kg everyday.
4.Lower lung artery high pressure:Nitric Pu sodium:Quiet drop, 1~3 μ gs(kg.min)/;Nitric acid glycerin:Quiet drop, the beginning measures to 5 μ g/mins, had better use a tiny pump;The prostaglandin E1:The quiet drop is 10 μ gs+the NS250 be mls or 5% GSs, once/d.
Note:The purple Gan heart attack didn’t need benefit urine; Nitric Pu sodium quiet drop beginning speed can slightly quick, the blood pressure is after descend can decrement slow, but used for mental exertion to crock up, the heart source shock start keep slow-moving, with 10 drop/minute is proper, hereafter consider feeling again to speed up, use the medicine should not be over 72 hours; The sufferer’s individual difference to the nitric acid glycerin is big, quiet the drop have never fix in keeping with quantity, should according to individual of blood pressure, heart rate and other blood dynamics parameter to adjust dosage.
14, heart valve disease
Diagnose important point:1.Since go toward to have rheumatism’s history or old age of the hot disease not a rheumatism heart valve pathological changes, wound heart valve pathological changes, the infection film inside the heart is burning, the coronary cause of the heart valve pathological changes, and valve glue a liquid to change sex cause of heart valve pathological changes.
2.Before the heart correspond valve area can smell and the heart miscellaneous sound.
3.Can cause heart Shuai, various heart Lyu to disorder(the building Zhan be more familiar), second impatient infection film inside the heart blaze and bolt to fill(bolt to fill to at most see) and it related symptom.
4.Check:The anti- streptococci dissolves the vegetable”O”(anti- O), the C responds that the egg white(CRP), red cell sinks to decline rate’s(ESR) etc. excrescent;The even slice, heart super voice of the electrocardiogram, chest moves diagram and much more colorful Pu Lei check ability to definitely diagnose.
The medicine cure:1.Strong heart:① Ground Gao Xin:The adult takes orally a 0.25 mgs/d;The child 0.06~0.08 mgs/kg under 2 years of age, 0.04~0.06 mgs/kg over 2 years of age, tasty or quiet note;② West ground orchid:Quiet note, 0.2~0.4 mgs/time, 1~2 times/d.
2.The benefit urine ① soon wets:The adult takes orally 20 mgs/d or 40 mgs/following day(need can add to the 120 mgs/d), or the muscle note or quiet note a 20~40 mgs/time;The child takes orally a 1~2 mgs/kg, can add quantity when it’s necessary;The ② hydrogen chlorine Mao Mao:The adult takes orally a 25~100 mgs/d and divide to take 1~3 times;(can add to the 100~200 mgs/d when it’s necessary, divide to take 2~3 times)The child takes orally a 2 mgs/(kg.d), divide 2 times to the medicine;The ③ ester inside the Luo:The adult takes orally a 20~40 mgs/time, 3 times/d.
3.Reduce a slow heart rate:The ① general Pa Tong:Take orally:Adult’s 100~200 mgs/time, 3~4 times/d, measure a 900 mgs/d very much, the child 5~7 mgs/kg, 3 times/d, reduce half behind since the effect, maintain curative effect;Quiet note:Adult’s 1~1.5 mgs/kg, quiet note for 5 minutes(re-usable when it’s necessary after 20 minutes once or 0.5~1 mgs/minute quiet drop maintenance), child every time 1 mg/kg, quiet note for 5 minutes;(re-usable when it’s necessary after 20 minutes once)The ② An iodine Tong:Take orally:200 mgs/time, 3 times/d(the after meal take), press to need to change to a 200~400 mgs/d maintenance after 1~2 weeks;Quiet note:5~10 mgs/kg, slow-moving infusion;Quiet drop:300 mgs/time, add the 250 ml physiology brine, in 30 minutes the drop be over.
4.Expand a tube:The card gives Pu benefit:The adult takes orally a 12.5 mgs/time, 2~3 times/d;(can increase to the 50 mgs/time when it’s necessary, 2~3 times/d)The child takes orally to start a 0.3 mgs/kg, 3 times/the d increases a 0.3 mgs/kg every 8~24 hour when it’s necessary, is not over the 6 mgs/kg everyday.
Note:If there is rheumatism performance needing anti- rheumatism a treatment;For have the heart Shuai the omen, as early as possible and thoroughly cure, give cordial, diuretic etc. medicine treatment, for keeping heart Shuai from have a necessary long-term a little amount of use digitalis medicine;The pure Geng Zu heart valve film disease forbids to use a digitalis medicine;Breeze secret concern the sufferer be 30 years old following, every time round winter the spring stanza be proper to inject long effect be willing to the mildewed be plain 1,200,000 units/monthses, carry on a prevention, popular the period even wants to carry on prevent°froming sex inject in the upper respiratory infection;Merge building Zhan’s etc. may cause the sufferer whom the blood bolt the normal regulations anti- blood platelets and anti- Ning a treatment.
15, the advanced case muscle have no dint
Diagnose important point: 1, the bottom of the eyelids hang, have another the companion has already replied to see, look awry, see not pure, eyes shut to match not whole, the eyeball movable hand limit, wake up in the morning late heavy; The arms and legs has no dint, many in the neck soft rise have no dint or mouth to chew have no dint breath spirit short, have no dint and swallow not and smoothly etc. the symptom mutual connection, but with swallow difficult related symptom to contain not pure Ju sound, voice hoarse, the drinking Qiang cough, the mouth chew have no dint etc..
2, check:The clear experiment of the new Si masculine gender;The E.M.G. again gives or get an electric shock to stimulate Shuai to reduce in above 10%.
The medicine cure:1.Take orally strong loose:Take orally a 10~20 mgs every morning, and increase a quantity every week, increase to the 70~100 mgs about around January amount of, and change to a following day.
2.The sulphur Shi Biao purine:Take orally a 50~150 mgs/d.
3. The bromine is clearer than the new Si’s:Take orally a 15 mgs, 3~4 times/d;The bromine ratio Mao Ding Si of clear:Take orally a 60~120 mgs, 3~4 times/d;Beautiful Si of clear:5~10 mgs, 3~4 times/d., .
Note:When inject new Si of clear can’t completely alleviate a crisis or again and again crisis happen, should immediately make windpipe to cut open, keep a breath way lucid to breathe with assistance.
16, coronary artery gruel the kind harden sex heart attack
Diagnose important point:1.Angina pectoris:The ① chest oppresses asphyxiation feeling, stuffy bulge feeling and violently burn bright kind ache, general ache keep on 1-5 minutes, accidentally have as long as 15 minutes, can alleviate by oneself;The ② ache often projects to left shoulder, left arm ex- seamy side until little finger and ring finger;The ③ ache appears when the heart burden aggravate(for example physical strength activity increment, the excesssive spirit stimulate and catch cold), at rest or tongue the bottom contain to take nitric acid glycerin for few minutes after then disappear;When ④ ache go into action, can the companion have(can also not the companion have) debility, perspire, the breath be short, worried, heart palpitates, disgusted or dizzy symptom;The ⑤ angina pectoris may also come from an other to make heart burden to excessively aggravate of disease, for example anemic, aorta petal disease, heart Lyu not and together, thyroid gland function the Kang is into etc..
2.Myocardial infarction:① Abrupt hour after the breastbone or area acute pain before the heart, to left shoulder, left arm or elsewhere project, and ache keep on half an hour above, through rest with contain to take nitric acid glycerin can’t alleviate;The ② breath short, dizzy, disgusted and cold war, many the sweat, pulse be small;The ③ skin is damp and cold, grey, the sickly appearance of heavy disease;④ About very its a the patient’s only performance be dizzy Jue or shock.
The medicine cure:1.Alleviate ache:Nitric acid glycerin, the 0.3~0.6 mgs contains to turn;Eliminate to deplore greatly a 5~10 mgs to contain to turn;The Xin Kang slowly releases a slice to take orally a 20~40 mgs, once/d;Take orally 30~60 mgs more according to Mu, once/d;The Lu south slice of Xin Kang takes orally a 20 mgs, 3 times/d;Cold bottom of the skin or muscle of the D 50~100 mg of the morphine 5~10 mgs or degree inject.
2.Anti- Ning with dissolve to bolt:Do obeisance department Linkao take a 100 mgs, once/d;The wave signs a Wei(the chlorine Mao Luo thunder) slice to take orally a 75 mgs, once/d;Hua method Linkao takes a 2.5~5.0 mgs, once/d;The urine arouses Mao 1,500,000 Us+NS100 ml, the quiet drop is 30 minutes.
3.Regulate a blood fat:Sign the Pu secure slice takes orally a 10 mgs, once/d;Comfortable decline it to take orally a 20 mgs, once/d;The blood fat Kang takes orally a 0.3 gs, 2 times/d.
4.The anti- heart Lyu disorder:Benefit many cards because of quiet push a 0.5~1 mgs/kg(<100 mgs/time) for 3~5 minutes, when it’s necessary 10~15 minutes repeated;Insight Anne takes orally a 5~10 mgs/time, 3 times/d;The difference fights to settle a 5~10 mgs+NS20 ml quiet push for 5~10 minutes, every 15 minutes re-usable 1~2 times, invalid namely stop.
5.Ease the myocardial lacks blood harm with contract Geng dead scope:The nitric acid glycerin 0.3 mg × weight(Kg)+the NS go to a 50 mls, 1 ml/h;(namely 0.1 ugs/kg.min)The nitric Pu sodium 0.3 mg × weight(Kg)+the NS go to a 50 mls, 0.1~5 ugs/kg.min.
Note:Artery’s building a shadow is the gold standard which diagnoses a coronary;Cure the coronary should live regulation, notice Lao Yi to combine and avoid too tired with once make an effort fierce, quit smoking, little alcohol, eat the animal fat less and contain cholesterol have another of food, and aggressive treatment high blood pressure, diabetes and Gao Xie3 Zhi’s disease;Merge heart Shuai and heart Lyu disorder hour need to add to use to rectify the treatment that heart Shuai and anti- heart Lyu disorder, can go a get involved of coronary treatment(PTCA+support Shu) when it’s necessary, severity can consider that carrying on surgery takes bridge surgical operation
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