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Jingdong book

住院医师查房医嘱手册丛书：实用心血管内科查房医嘱手册

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Jingdong book

住院医师查房医嘱手册丛书：实用心血管内科查房医嘱手册

Name: 住院医师查房医嘱手册丛书：实用心血管内科查房医嘱手册
Brand: Jingdong book
SKU: 3117100931
Price: 26.27 USD
Availability: OutOfStock

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《住院医师查房医嘱手册丛书：实用心血管内科查房医嘱手册》为“十二五”国家重点图书，全程查房示教，动态情景教学、临床医嘱示范，规范医嘱行为、实际病例教学，培养临床思维、重点突出简明，实用小巧便携。

Content Description

《住院医师查房医嘱手册丛书：实用心血管内科查房医嘱手册》共分9章，涵盖了心血管内科疾病谱的主要部分，如心力衰竭、心律失常、冠心病、高血压和心脏瓣膜病、心肌病等。《住院医师查房医嘱手册丛书：实用心血管内科查房医嘱手册》的特点是临床实用性突出，注重基础知识和基本技能的培训，既有简洁的理论介绍，又将重点放在对疾病的发展、治疗、转归的观察上；从患者的入院症状和体征的评估到辅助检查的分析，到治疗的医嘱示范及预后评估，系统地描述了心血管内科疾病的诊治思路；并提供实际病例分析，以强化理论知识的临床应用。

Author Description

李虹伟，教授，1965年6月出生，现任首都医科大学附属北京友谊医院心血管中心主任、主任医师、首都医科大学教授、博士生导师。美国威斯康星医学院心血管中心、美国阿肯色医科大学分子生物学系博士后。目前担任中华医学会心血管病分会、中国医师学会心血管内科分会、中国中西医结合学会诊断分会、中华医学会北京分会心血管专业委员会等专业委员会会员。任《中华心血管病杂志》、《中国心血管杂志》、《中国循环杂志》、《中国全科医学杂志》等杂志编委、通讯编委及杂志审稿人。
长期从事心血管内科的临床、科研和教学工作，具有丰富的临床经验，曾获得美国心脏病学会（AHA）博士后基金资助，目前承担多项国家自然科学基金、北京市自然科学基金、教育部博士点基金。参与多项国际多中心、大规模临床试验工作。主要研究方向是糖代谢异常与冠心病的关系的基础和临床研究，曾获北京市卫生局科技二等奖等多项奖项；在Diabetes、Circulation Research、AP等国际著名SCI期刊发表文章15篇，在国内核心期刊发表文章60余篇。主编、主译、参编著作10余部，如《临床药理学心血管分册》、《急性冠状动脉综合征》等。已培养博士、硕士牛22人。

Catalogue

第1章心力衰竭
第一节急性心力衰竭
第二节慢性心力衰竭

第2章心脏性猝死
第3章心律失常
第一节缓慢性心律失常
病态窦房结综合征
房室传导阻滞
第二节快速性心律失常
窦性心动过速
室上性心动过速
室性心动过速

第4章高血压病
第5章冠状动脉粥样硬化性心脏病
第一节稳定型心绞痛
第二节急性ST段抬高性心肌梗死
第三节不稳定型心绞痛／非ST段抬高性心肌梗死
第四节冠心病的其他表现形式
变异型心绞痛
X综合征
无症状性心肌缺血

第6章心脏瓣膜病
第一节二尖瓣狭窄
第二节二尖瓣关闭不全
第三节主动脉瓣狭窄
第四节主动脉瓣关闭不全

第7章感染性心内膜炎

第8章心肌炎和心肌病
第一节心肌炎
第二节心肌病
扩张型心肌病
肥厚型心肌病
限制型心肌病
致心律失常型右室心肌病
围生期心肌病
酒精性心肌病

第9章心包疾病
第一节急性渗出性心包炎
第二节缩窄性心包炎
缩略词

Book Abstract

概述
心肌炎（myocarditis）是指由各种病因引起的心脏局限性或弥漫性的炎性病变。炎性病变可累及心肌、间质、血管、心包或心内膜。其病因可以是各种感染、自身免疫反应及理化因素，主要通过三种基本机制造成心肌损害：①直接侵袭心肌；②产生心肌毒素，如白喉；③免疫介导心肌损害。病程可以是急性（3个月以内）、亚急性（3～6个月）和慢性（半年以上）。心肌炎临床表现通常与受损心肌的量有关。轻型心肌炎的临床表现较少，诊断较难，故病理诊断远比临床发病率高。
入院评估
一、病史询问要点
（一）起病因素
1.感染因素
（1）病毒在我国病毒性心肌炎较常见。目前已知能引起心肌炎的病毒有20余种，其中以引起肠道和上呼吸道感染的病毒最常见，主要有柯萨奇病毒B组、埃可病毒及腺病毒，还有流感病毒、腮腺炎病毒、肝炎病毒及副流感病毒等。
（2）细菌细菌感染中以白喉为最著；伤寒也不少见；两者都因细菌毒素的作用而导致心肌受损。心内或心包的细菌感染可延及心肌而引起心肌炎，致病菌以葡萄球菌、链球菌或肺炎球菌为多。此外，脑膜炎球菌菌血症、脓毒血症、布氏杆菌病、破伤风等时亦可发生心肌炎。
（3）其他如立克次体、螺旋体、真菌感染均可引起心肌炎。
2.过敏或变态反应所致的心肌炎青霉素、磺胺类、甲基多巴、抗结核药（异烟肼、链霉素、对氨基水杨酸钠）、依米丁、保太松、吲哚美辛、金霉素、利尿药都可因过敏或变态反应引起心肌炎。牛痘和破伤风抗毒素都可因过敏而造成死亡。
3.内分泌和代谢紊乱如低血钙、低血镁、高磷血症、低磷血症、甲状腺功能亢进、甲状腺功能减退、儿茶酚胺分泌过多等也可引起心肌炎。
4.理化因素引起的心肌炎化学毒物或药物除通过过敏反应外，还可由直接毒性作用引起中毒性心肌炎。依米丁、砷、三价锑、酒精、钴、去甲肾上腺素、磷、一氧化碳、汞、铅、蛇毒、蝎毒等都可引起心肌炎。心脏区经受过度放射线照射也可引起心肌炎。
5.结缔组织病系统性红斑狼疮尸检有8%～50%病例有活动性心肌炎，类风湿患者尸检10%～20%并发非特异性间质性心肌炎，硬皮病和结节性多动脉炎都可并发心肌炎。
（二）主要症状
病毒性心肌炎的主要临床表现为：出现心肌炎前1～3周常有上呼吸道及消化道病毒感染的表现，如发热、咽痛、肌痛、腹泻等；轻症者可无不适，也可出现心悸、胸痛、胸闷、乏力、气短及心前区不适等非特异性症状。重症者可出现急性心力衰竭、心源性休克、肺和体循环栓塞、猝死等；心律失常可见室性早搏、室性心动过速，房室传导阻滞。迁延为慢性心肌炎者也可出现心脏扩大和反复心力衰竭。
二、体格检查要点
体征可见心率增快且与体温升高不成比例，各种类型的心律失常。叩诊心脏可扩大，第一心音减弱，心尖区可闻及收缩期杂音或舒张期奔马律等。
三、门诊资料分析
（一）血常规十红细胞沉降率
白细胞总数增加（中性粒细胞增高），红细胞沉降率增快。
……

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