Saturday, November 13, 2010

What is rheumatic heart disease, drug treatment

What is the treatment of rheumatic heart disease rheumatic heart disease drug treatment the following points: 1, asymptomatic phase of the treatment of rheumatic heart disease treatment principle is to maintain and enhance the compensatory function of the heart, one should avoid heart excessive load, such as heavy manual work, strenuous exercise, on the other hand should also note that combining static and dynamic, within its capacity to adapt to make some activity and exercise, to strengthen health, improve the heart's reserve capacity. Appropriate physical activity and rest, limiting sodium intake and the prevention and treatment of respiratory tract infection. Attention to the prevention of rheumatic fever and infective endocarditis. With heart failure, the use of digitalis preparations, diuretics and vasodilators. 2, treatment of complications of rheumatic heart disease: 1) the treatment of heart failure; 2) the rescue of acute pulmonary edema; treatment of acute pulmonary edema caused by acute left heart failure and pulmonary edema is similar to the difference is not with the expansion small arteries dilate blood vessels based drugs and cardiac drugs, when there is rapid atrial fibrillation, only to be used cedilanid reduce ventricular law. When the company of acute fat fast Room law is preferable to reduce the ventricular cedilanid law. 3) Control and elimination of atrial fibrillation. 3, rheumatic heart disease in the surgical treatment of chronic rheumatic heart valve disease and asymptomatic, generally do not need surgery; symptoms are indications for surgery and who can be either isolated mitral valve replacement surgery or artificial, artificial valve replacement surgery for the treatment of adults with aortic valve stenosis of the main method. 1) The operation to adapt to sign: no obvious symptoms of heart function in patients without surgical treatment of grade ��. Cardiac function �� �� patients should be treated surgically. Cardiac function should be a mandatory grade �� heart, diuretic and other therapy to improve heart function until after the surgery. Associated with atrial fibrillation, pulmonary hypertension, embolism and functional circulation tricuspid regurgitation are advised surgery. However, increased surgical risk. With rheumatic activity or bacterial endocarditis should be in complete control of active rheumatism and endocarditis 6 months after the surgery again. 2) surgical methods: mitral stenosis mitral valve surgery and dissection at the junction of two types of mitral valve replacement. The former was divided into two kinds of closed and open heart dissection. Closed mitral junction dissection: usually 4 or 5 left intercostal incision into the chest, longitudinal incision of the pericardium, the left atrial appendage at the base to make a purse suture, the surgeon index finger through the left atrial appendage into the left atrial incision exploration mitral valve. In the avascular zone, left ventricular mitral valve into the expansion, under the guidance of the index finger, through the mitral valve dilator, successive expansion, each expansion, the expansion should be back to the left ventricle is closed, the second probe tip of the index finger separation of valve junction, with or without regurgitation. Look directly at the junction of separation of mitral valve surgery; for the right or left atrial appendage small room with thrombosis. Cardiopulmonary bypass surgery should be carried out by longitudinal median sternotomy incision, insert the arterial and venous tubes, cardiopulmonary bypass perfusion began, the room groove cut into the left atrium to expose the mitral valve, cut the fusion junction, adhesion and fusion of separate tendons. Mitral valve replacement: valve disease for severe leaflet calcification, stiffness, contracture, or mitral chordae junction adhesion after dilatation with severe traumatic mitral insufficiency. Surgery under cardiopulmonary bypass, excision of the mitral valve lesions, implantation of artificial biological valve or mechanical valve. One. Western medicine treatment of rheumatic fever involving the heart should be absolute bed rest and hospitalization. Selection of antibiotics kill streptococcus, sensitive antibiotics such as penicillin 400 million u ~ 800 �� u, VD, 1 / d, for 10 to 14 days, then 800 000 u, im, 2 / d. When the ASO is normal, to long-acting penicillin preparations 120 million u, im, 1 / d, share 5 years, applied to 16-year-old children; salicylic acid preparations: Select enteric-coated aspirin, adult 4 ~ 6g / d, 100 ~ 150mg/kg body weight in children, 3 to 4 minutes immediately after a meal served to relieve gastrointestinal symptoms, if necessary, aluminum hydroxide gel serving. Even for 3 to 6 months, reduction to 2g / d, continuing to 1 year; adrenal cortex hormones: high fever when available hydrocortisone 100mg +100 ml liquid, VD, 1 / d, after the switch to the strong temperature control Song 30 ~ 40mg, 1 / morning, oral, 2 weeks after the reduction, every 3 days by 2.5mg, up to 5mg, 1 / morning, after 8 weeks of continuous use of withdrawal. When complete control of rheumatic activity, the rest still have myocarditis 2 weeks, then gradually increase the volume of activity. (A) of the mitral stenosis: Massive take seats, with sedatives such as stability, and other diuretics such as furosemide; treatment of acute pulmonary edema caused by acute left heart failure and pulmonary edema is similar to the difference is not with the expansion of small arteries dilation of blood vessels based drugs and cardiac drugs, when there is rapid atrial fibrillation only when required cedilanid reduce ventricular law. When the company of acute fat fast Room law is preferable to reduce the ventricular cedilanid law. Right ventricular failure should be low-salt diet, diuretics and digoxin-based treatment. (B) mitral regurgitation: 1) medical treatment: attention to the prevention of rheumatic fever and infective endocarditis. Appropriate physical activity and rest, limiting sodium intake and the prevention and treatment of respiratory tract infection. With heart failure, the use of digitalis preparations, diuretics and vasodilators. 2) surgical treatment: to restore the integrity of the underlying valvular measures should in the event of irreversible left ventricular dysfunction before the implementation of prosthetic valve replacement. (C) aortic stenosis: 1) medical treatment: prevention of rheumatic fever and infective endocarditis, regular review. Moderate and severe stenosis, limiting physical activity, prevention of angina, syncope and heart failure. Heart failure sodium restriction, use of digitalis preparations, careful application of diuretics. 2) surgical treatment: severe aortic stenosis associated with angina, syncope, or heart failure as the main indications for surgery, artificial heart valve replacement surgery for the treatment of adults with aortic valve stenosis of the main method. (Iv) aortic valve insufficiency: 1) medical treatment: prevention of rheumatic fever and infective endocarditis. 2) surgical treatment: artificial heart valve replacement aortic valve regurgitation is a serious primary treatment. II. Chinese medicine treatment 1) blood stasis mainly: palpitations, anxiety, chest tightness, uncomfortable, sad, made, rather then the cough with hemoptysis, the two zygomatic purple, a purple lips, tongue or dark purple bruise, treatment principles: blood of stasis, qi meridians. 2) qi and blood deficiency mainly: palpitations, shortness of breath, dizziness, fatigue, minimalist looking, poor sleep, pale tongue, weak pulse. Treatment principle: blood nourishing the heart, Qi Anshen.

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