主动脉瓣置换术后的护理PPT.pptVIP

主动脉瓣置换术后的护理 The nursing of aortic valve replacement 正常的主动脉瓣有三个瓣叶：左半月瓣、右半月瓣和后半月瓣 心室舒张期Ventricular diastole 心室收缩期 Ventricular systole  心内膜下心肌缺血和灌注不足 aortic stenosis 脑血流灌注下降 左心室做功 心肌耗氧量 顺应性下降 舒张末压力 CO 冠状动脉平均灌注压 心绞痛 晕厥 Angina pectoris Syncope 急性Acute : 1.感染性心内膜炎 Infective endocarditis 2.主A夹层 Aortic dissection 3.外伤 Trauma 4.人工瓣膜撕裂 Prosthetic valve tear 慢性Chronic: 主动脉瓣疾病 Aortic valve disease 2/3为风心病 主动脉根部扩张 Aortic root dilatation 主动脉瓣关闭不全的病因Causes of aortic incompetence 主动脉瓣纤维化、增厚、缩短、变形 主动脉瓣关闭不全 Aortic valves incompetence 主动脉内血液在舒张期返流入左室 偏心性肥厚、扩大 左心衰 左心室容量负荷 Sp?、Dp? 左心室舒张末期压力 CO 室壁张力 心绞痛 pulmonary hypertension 右心衰 pathophysiology 反流面积的大小 心动周期舒张期的长短 体循环血管阻力 AI reverse flow Reverse flow aera of the size Beckoning cycle diastolic length Systemic vascular resistance 急性主动脉瓣关闭不全 左心室舒张期充盈量突然增加 压力迅速增高 左房压、肺静脉压迅速升高 急性肺水肿 心动过速以减少反流量 增加CO 二尖瓣舒张期提前关闭，缓解左房和肺静脉受左心室高舒张压的影响 CO减少，低BP 急性左心衰竭 急性AI 瓣膜置换术是用人工机械瓣或生物瓣进行替换人心脏瓣膜进行置换 Valve replacement surgery is to use mechanical valves or biological valves to replace original human valves. 主动脉瓣置换术 病例介绍 Case Introduction 病史medical history 罗菊梅，女，40岁,云南镇雄人 Patient Jumei Luo,female,40 years old, from Zhenxiong in Yunnan province. 患者因头昏、胸痛3年，近一年来加重，活动后心悸、气促、乏力伴呼吸困难，休息后无明显缓解一月余，于2014年12月10日以“非风湿性主动脉瓣狭窄并关闭不全”收住 She was admitted to the hospital for Non-rheumatic aortic stenosis and incompetence on December 10th,2014.because dizziness, chest pain have last three years, heart palpitation and shortness of breath with increased activities , and exertional dyspnea lasting over a month. Medical History ◇手术史Surgical operation history 2004年行“ 卵巢囊肿摘除术” ovarian cyst in 2004, 2011年行“右上臂神经源性肿瘤切除术” “neurogenic tumor resection of right arm” in 2011 ◇过敏史Allergic history 双黄连 Echocardiography: 1、Aortic valve disease: moderate aortic incompetence, moderate aortic stenosis, and the widening of aortic diameter 2、Mild mitral incompetence, and