常見癥狀發(fā)紺課件

常見癥狀發(fā)紺ppt課件匯報(bào)人：文小庫2024-03-15CONTENTS發(fā)紺基本概念與定義發(fā)紺診斷方法與技巧常見類型發(fā)紺及其特點(diǎn)鑒別診斷與誤區(qū)提示治療原則與方法探討預(yù)防措施與生活習(xí)慣調(diào)整建議發(fā)紺基本概念與定義010102發(fā)紺定義及特點(diǎn)特點(diǎn)為在皮膚較薄、色素較少及毛細(xì)血管豐富的部位（如唇、指、甲床等）表現(xiàn)更為明顯。發(fā)紺是指血液中去氧血紅蛋白增多導(dǎo)致皮膚和黏膜出現(xiàn)青紫色改變。導(dǎo)致血氧含量降低，如先天性心臟病、慢性阻塞性肺病等。血紅蛋白異常或血液循環(huán)障礙，如高鐵血紅蛋白血癥、硫化血紅蛋白血癥等。如雷諾現(xiàn)象、血栓閉塞性脈管炎等導(dǎo)致ju部血液循環(huán)障礙。心肺疾病血液疾病ju部因素發(fā)病原因及機(jī)制以下附贈(zèng)各項(xiàng)管理制度英文版（不需要可刪）急救藥品、器材管理制度:1.Rescuedrugsandequipmentshouldbe"fivefixed"(fixedquantityandvariety,designatedplacement,designatedpersonstorage,regulardisinfectionandsterilization,regularinspectionandmaintenance)and"twotimely"(timelyinspectionandmaintenance,timelyreceiptandsupplementation).Theitemisclearlymarkedandcannotbeusedarbitrarily.2.Thenecessaryrescueequipmentiscomplete,ingoodperformance,andinstandbycondition.3.Therescuedrugsarecomplete,withcleardruglabelsandnodiscoloration,deterioration,expiration,ordamage.Theyshouldbeplacedandusedintheorderofdrugexpirationdates(fromrighttoleft).4.Emergencydrugsanditemsforeachdepartment'srescuevehicleshallbeuniformlyequippedaccordingtorequirements.Specializedemergencydrugsanditemsmustbereviewedandapprovedbythedepartmentdirectortodeterminethetype,quantity,specifications,anddosagetobeequipped.Rescuevehiclesmustbeplacedindesignatedlocationsandmanagedbydesignatedpersonneltoensuresafetyandeaseofuse.5.Afterusingrescuedrugsandequipment,theyshouldbefullyreplenishedwithin24hours.Iftheycannotbereplenishedduetospecialreasons,theyshouldbenotedonthehandoverregistrationformandreportedtotheheadnurseforcoordinationandresolutiontoensuretimelyuseduringpatientrescue.6.Thereisaregistrationbookfortheprovisionofdrugsandequipment.Ensureconsistencybetweenaccountsandmaterials,andhandoverbetweenshifts.7.Managementofsealedrescuevehicles:Beforesealing,theheadnurse(ornurseincharge)andanothernurseshallcountthedrugsandequipmentaccordingtotheregistrationbookofdrugandequipmentequipment,verifytheiraccuracy,andsealthemwithaseal.Twopeopleshallsignandfillinthesealingtime.Nurseschecktheconditionofthesealsoncepershiftandcompletethehandover.Theresponsiblenursescheckonceaweek,andtheheadnurseandresponsiblenursesopenthesealsandinspectthedrugsandequipmentintheambulanceonceamonth,withrecordskept.8.Nonsealedrescuevehiclemanagement:Eachshiftshallcountthedrugsandequipmentaccordingtotheregistrationbookandcompletethehandover.Theresponsiblenurseshallinspectonceaweek,andtheheadnurseshallinspectonceeverytwoweeksandkeeprecords,ensuringthattheaccountsmatchthematerials.護(hù)理文書書寫制度:

1.Nursingstaffstrictlyfollowthelatestrequirementswhenwritingnursingmedicalrecords.2.Thecontentofnursingrecordsshouldbeobjective,truthful,accurate,timely,complete,andstandardized.3.Allnursingdocumentsshouldbewrittenwithablueblackorcarboninkpen.4.AllnursingdocumentsshouldbewritteninArabicnumeralsfordateandtime,withdatesinyears,months,anddays,usinga24-hoursystem,specifictominutes.5.WritingshoulduseChinese,medicalterminology,andcommonlyusedforeignlanguageabbreviations;Completerecorditems;Thetextisneat,thehandwritingisclear,andthelayoutisclean;Accurateexpression,fluentsentences,simpleandconcise:correctformatandpunctuation,notypos.6.Whenerrorsoccurduringthewritingprocess,doublelinethemonthewrongwords,keeptheoriginalrecordclearanddistinguishable,signthemodifier,indicatethemodificationtime,continuetowritethecorrectcontent,anddonotusescraping,sticking,paintingorothermethodstocoveruporremovetheoriginalhandwriting.Eachpageshouldbemodifiednomorethantwotimes,otherwisetheoriginalrecorderwillpromptlycopyagain(exceptformodificationsmadebysuperiors).7.Nursingrecordswrittenbyinternnurses,probationarynurses,orunregisterednursesshouldbereviewedandsignedbynurseswithlegalprofessionalqualificationsinthismedicalinstitution.8.Furthertrainingnursescanonlywritenursingdocumentsafterbeingrecognizedbythemedicalinstitutionreceivingthetrainingfortheirworkability.9.Superiornursingstaffhavetheresponsibilitytoreviewandmodifythewrittenrecordsofsubordinatenursingstaff.Whenmakingmodifications,reddoublelinesshouldbeusedtomarkerrors,writethemodifiedcontent,signandindicatethemodificationtime.10.Temperaturerecords,medicalorders,patientcarerecords,andsurgicalinventoryrecordsshouldbearchivedontime.中心性發(fā)紺周圍性發(fā)紺混合性發(fā)紺特殊類型發(fā)紺臨床表現(xiàn)與分類全身性發(fā)紺，除四肢及顏面外，亦見于黏膜和軀干，皮膚溫暖。中心性與周圍性發(fā)紺同時(shí)并存，常見于全心衰竭。常出現(xiàn)于肢體末端與下垂部位，ju部皮膚發(fā)涼。如高鐵血紅蛋白血癥引起的發(fā)紺，呈棕褐色，經(jīng)硫黃粉末或維生素C揉搓可消退。發(fā)紺診斷方法與技巧02病史采集與體格檢查病史采集詳細(xì)詢問患者發(fā)紺出現(xiàn)的時(shí)間、部位、伴隨癥狀等，了解有無相關(guān)疾病史，如心肺疾病、血液系統(tǒng)疾病等。體格檢查觀察發(fā)紺的部位、范圍、程度等，檢查心肺功能，聽診心臟雜音、肺部呼吸音等，評(píng)估患者的整體狀況。檢查血紅蛋白含量、紅細(xì)胞計(jì)數(shù)等，了解貧血程度及類型。測定動(dòng)脈血氧分壓、二氧化碳分壓等，判斷機(jī)體缺氧及酸堿平衡狀況。檢查肝腎功能、電解質(zhì)等，了解機(jī)體代謝狀況及內(nèi)環(huán)境穩(wěn)定性。血常規(guī)血?dú)夥治鲅荷瘜?shí)驗(yàn)室檢查項(xiàng)目選擇觀察肺部病變、心臟大小及形態(tài)等，評(píng)估心肺功能狀況。檢查心臟電生理活動(dòng)，了解心律失常、心肌缺血等異常情況。觀察心臟結(jié)構(gòu)及功能，評(píng)估心臟瓣膜狀況、心肌運(yùn)動(dòng)等。如CT、MRI等，可根據(jù)具體病情選擇，進(jìn)一步明確診斷。胸部X線片心電圖超聲心動(dòng)圖其他影像學(xué)檢查影像學(xué)檢查在診斷中應(yīng)用常見類型發(fā)紺及其特點(diǎn)03中心性發(fā)紺是由于心、肺疾病導(dǎo)致動(dòng)脈血氧飽和度降低而引起的。其特點(diǎn)為全身性發(fā)紺，除四肢與面頰外，亦見于黏膜（包括舌及口腔黏膜）與軀干的皮膚，但皮膚溫暖。特點(diǎn)中心性發(fā)紺常見于急、慢性呼吸系統(tǒng)疾病、心臟疾病等，如重癥肺炎、肺水腫、肺栓塞、慢性阻塞性肺疾病、先天性心臟病、心力衰竭等。常見疾病中心性發(fā)紺特點(diǎn)周圍性發(fā)紺是由于周圍循環(huán)血流障礙所致。其特點(diǎn)為發(fā)紺常出現(xiàn)于肢體的末端與下垂部位，如肢端、耳垂與鼻尖，且這些部位的皮膚溫度低、發(fā)涼，若按摩或加溫耳垂與肢體末端，可使發(fā)紺消退。常見疾病周圍性發(fā)紺常見于休克、嚴(yán)重寒冷、雷諾現(xiàn)象等。周圍性發(fā)紺特點(diǎn)混合性發(fā)紺是指中心性發(fā)紺與周圍性發(fā)紺同時(shí)存在，常見于全心衰竭。其特點(diǎn)為發(fā)紺范圍廣，程度重，既可見于肢體的末端與下垂部位，又可見于黏膜和軀干皮膚，且皮膚溫度低。常見疾病混合性發(fā)紺常見于全心衰竭、嚴(yán)重感染、嚴(yán)重貧血等疾病。這些疾病可導(dǎo)致心、肺等多個(gè)器官功能障礙，引起動(dòng)脈血氧飽和度降低和周圍循環(huán)障礙，從而出現(xiàn)混合性發(fā)紺?；旌闲园l(fā)紺鑒別診斷與誤區(qū)提示04發(fā)紺時(shí)皮膚和粘膜呈現(xiàn)青紫色，而蒼白則是皮膚和粘膜失去血色，呈現(xiàn)蒼白色。兩者在顏色上有著明顯的區(qū)別。發(fā)紺與蒼白發(fā)紺是由于血液中去氧血紅蛋白增多引起的，而黃疸則是由于血液中膽紅素升高引起的。黃疸時(shí)皮膚、鞏膜等呈現(xiàn)黃色，與發(fā)紺的青紫色有所不同。發(fā)紺與黃疸類似癥狀區(qū)分要點(diǎn)對(duì)發(fā)紺認(rèn)識(shí)不足部分醫(yī)生對(duì)發(fā)紺的認(rèn)識(shí)不足，可能將其與其他類似癥狀混淆，導(dǎo)致誤診。忽視病史和體格檢查在診斷過程中，如果醫(yī)生忽視患者的病史和體格檢查，也可能導(dǎo)致誤診。例如，未詢問患者是否有心肺疾病史，未對(duì)患者進(jìn)行詳細(xì)的體格檢查等。誤診原因分析醫(yī)生應(yīng)加強(qiáng)對(duì)發(fā)紺相關(guān)知識(shí)的培訓(xùn)，提高對(duì)發(fā)紺的認(rèn)識(shí)和診斷能力。在診斷過程中，醫(yī)生應(yīng)重視患者的病史和體格檢查，結(jié)合患者的臨床表現(xiàn)進(jìn)行綜合判斷。在必要時(shí)，醫(yī)生可借助血液檢查、心電圖、胸部X線等輔助檢查手段，進(jìn)一步明確發(fā)紺的原因和診斷。加強(qiáng)發(fā)紺相關(guān)知識(shí)培訓(xùn)重視病史和體格檢查借助輔助檢查手段提高診斷準(zhǔn)確率策略治療原則與方法探討0503周圍循環(huán)障礙引起的發(fā)紺改善ju部血液循環(huán)，如保暖、按摩等，促進(jìn)血液流通，緩解發(fā)紺癥狀。01心臟疾病導(dǎo)致的發(fā)紺治療心臟疾病，如先天性心臟病、心力衰竭等，改善心臟功能，提高血氧飽和度。02呼吸系統(tǒng)疾病引起的發(fā)