Therapeutic measure _'s treatment of the viral myocarditis

Therapeutic measure _'s treatment of the viral myocarditis
(1) Generally treat1.It is quite important to have a rest. It can make the condition become more serious that activity sum is tired. Acute one stays in bed after heat is returned for 3- 4 weeks, the heart shadow returns to normal, the slight activity of starting to leave the bed. Should continue limiting the activity in convalescence, treat the condition steady, and then increase activity progressively. The condition is relatively serious, cardiac enlargent person, lie in bed for about 6 months, such as the heart has not obviously shrunk, should lengthen appropriately to lie in bed for time. There are the complete one of heart functions, should absolutely stay in bed, in order to lighten the heart burden, it make decline heart controlling,after take a favorable turn heart situation,beginning can activities slight. The above of half a year that the general serious disease infant needs to stay in bed; The light disease infant is such as only having arrhythmia of fighting early etc., can shorten lying in bed at break appropriately.2.Antibiotic although to causing the virus of myocarditis not to act on directly, the bacterial infection is the important condition factor of the viral myocarditis, so while beginning to treat, maintain that uses antibiotic appropriately. The blue and green mould skin note of general application is 1- 2 weeks, in order to remove streptococcus and other sensitive bacteria. 3.Protect the cardiac muscle ( 1) The application against oxidant: Heavy dose of vitamin C have, increase, preceded the intersection of form and the intersection of blood vessel and blood flow volume, glycogenic, myocardium contractile force of cardiac muscle, improve the heart function, remove free radical, repair the function that the cardiac muscle damages. The dosage is 100- 200mg/kg day, soluble in the intravenous injection in 10- 25% of the glucose liquid 10- 30ml, 1 times a day, it is a course of treatment in 15- 30 days; The Vitamin E is important lipid-soluble antioxidant of organism, mainly distribute over mitochondrial membrane, inner quality network and serous coat, removing internal and external free radicals of cell, inhibit lipid of the membrane from crossing and oxidizing reacting, protecting cell membrane,etc. respect and playing an important role. The dosage is 100mg, take orally three times in one day; Coenzymatic Q10 is Vitamin E -like to resist the oxidation, can inhibit lipid of the biomembrane from passing and oxidizing reacting, reduce LPO to produce, thus protect cell membrane and inferior cell composition. The dosage is 5mg, the skin note, can use together for 1- 3 months once a day. ( 2) The medicine of the cardiac muscle of nutrition: Mixture of energy: ATP 20mg, coenzymatic A50- 100 , vitamin B6100mg, cytochrome C15mg add 10- 20% of the glucose liquid 100- 250ml veins to instil, 1 times a day, 10-30 one course of treatment (the intersection of cytochrome and C need, make irritated to test use) . Polarise the liquid: ATP 20mg, coenzymatic A50- 100 ordinary insulinogenic 4- 6 , 10% chlorine potassium 5- 8ml, are soluble in 5- 10% of the glucose liquid 250ml the vein is instilled, once a day, it is a course of treatment that 10- 30 is second-class.The above-mentioned medicines strengthen myocardium nutrition, improve the myocardium function, damage and repair function on the cardiac muscle. (2) Application of the adrenocortical hormoneStill there is dispute at present in the application about cortical hormone, the majority thinks: The course of disease is early ' Namely have illness coming on in 18 days) And the light disease case needn't be used; Serious to spend more than atrio-ventricular block, in heart failure seriously etc. and should be used immediately such as brain syndrome of heart, heart source nature shock, II, the dosage should be great, the condition relieves decrement and stops medicines; Break out repeatedly or the person who delays condition, might relate to one's own immunity, so advocate using, oral prednisone 1- 1.5mg/kg/d of general case, 3- 4 weeks, symptom relieves decrement gradually, stops medicines; Use cases serious 8- 12mg/kg/ds loose when it do in the test while hydrogenating or if you can't last rice, last 0.2- 0.4mg/kg/d vein to instil. (3) It is in heart failure to controlAt the time of myocarditis, the cardiac muscle increases to foreign digitalis sensitiveness, tolerance is poisoned badly, incidently, should select for use, produce effects fast and the intersection of person who excrete preparation such as the west soon and blue or digoxin. The dosage should be partial and small, generally use 1/2- 2/3 of daily quantity. Can stop medicines in several days after the acute heart declines and controls. But to the exercise therapy in chronic cardiac insufficiency person, advocate employing partial a small amount of keeping amount of foreign digitalis for a long time more, until the heart function returns to normal. Diuretic should be used and used few early, pay attention to mending potassium at the same time, otherwise apt to cause the arrhythmia. Pay attention to supporting oxygen, keep quiet. If have the fidgets, can give sedative. It is not full-time that the acute left heart function happens, except that combine with the west in short term blue, diuretic, sedative, oxygen are sucked, should expand pharmaceuticals if phenol proper Lamine for the blood vessel ' 0.5- 1mg/kg) Accede to 10% the intersection of glucose and liquid ' 50- 100ml) The inner fast vein is instilled. Under the emergency, can dilute the vein to inject with half quantity slowly with 10% of the glucose liquid first, then instil other half a quantity vein. (4) Rescue source shock of heartBecause it is unable that the cardiac muscle shrinks, the ventricle is too fast (sex tachycardia, ventricle are fine and quiver such as the room) Or ventricle rate too slow ' If sinus slow, II degree and II aroused in interest spend the above block) Cause, so must correct rhythm of the heart in time disorderlily. The fast vein instils heavy dose of hormone, the vein at once of heavy dose of vitamin C is injected, for instance, blood pressure rises unstably, reuse 1- 2 hours later, it can spend 3- 5 times on the first day, change into 1- 2 times a day later later once every every 4- 8 hour; Step up the intersection of medicine and dopamine and the intersection of A and Lamine and spend, every the intersection of 200- 300ml and all plus 10- 20mg under liquid, the vein is instilled, according to blood pressure, adjust density and speed at any time; If there is atrio-ventricular block or slowness of heart rate that can be added into 5- 10% of the glucose liquid 250ml, instilled by different third base Epinephrine 0.25- 1mg. Can fail use medicine, whole blood or blood plasma supplement the intersection of blood and capacity, must careful to prevent the lung edema from; Guarantee liquid quantity, offer according to 1000- 1200ml/m2/d, if there is acidosis and should be corrected in time; The oxygen is sucked.(5) It is not normal to correct the heart of serious rhythm of the heartThe correction of the arrhythmia lies in the absorption or repair of the myocardium pathological change. General slight arrhythmia such as fighting, I one degree of atrio-ventricular block,etc. early, does not need medicines to correct more, and mainly for myocarditis to treat synthetically. If the serious arrhythmia takes place like the fast arrhythmia, serious block should be corrected in time rapidly, otherwise majestic association's life.1.Shrink before one ' Fight early) Divided into a room, forming ' Juncture of room room) With room three kinds, among them with the room in order to see more. If many source, getting frequent to fight early, form, unite law, fight overlapping when on sinus T wave ahead early, in conformity with lidocaine of intravenous injection in time; Room rate getting slow and very careful to ask the intersection of product and vein instil with different third the intersection of base and Epinephrine or the intersection of A and hand. Select slow rhythm of the heart, the intersection of rhythm of the heart and flat, the intersection of B and the intersection of amine and the intersection of iodine and the intersection of furan and ketone, pairs of different third the intersection of pyrrole and amine, the intersection of Procaine and amide,etc. for use according to the circumstances. The room or forming is fought early, can select digoxin for use. Or other the intersection of and receptor block pharmaceutical, use rhythm of the heart instead to be flat different to fight definitely,etc..2.The intersection of sex and tachycardia can use mechanical La defy, press carotid sinus, La, defy person who swallow cause nausea the intersection of method and excited nervus vagus on the popping room, or adopt the intravenous injections such as blue, digoxin of the west of fast foreign digitalis preparation, or select rhythm of the heart for use flat, ATP,etc. treat. If companion's severe heart declines heart source shock,etc., can hit and reply law with the direct current synchronous electricity.3.The room room conducts and takes treatment of cause of disease as the core while hindering stagnat I, 2 degree. 2One degree of 2 types, one degree of atrio-ventricular block, except that the vein instils heavy dose of renal gland against quality hormone, can try out the base Epinephrine 0.5- 1mg of similarities and differences third and add into 5- 10% of the glucose liquid 250ml, instil, decrement is maintained after taking a favorable turn, or maintain by atropine 0.01- 0.03mg/kg hypodermic injection once or intravenous foreign note, or plant into the permanent pace maker.4.Atrium quiver and flutter at first using blue the west, can also with different to fight, park, propranolol. If medicine fail to respond to any medical treatment, can the intersection of power consuming and rhythm of the heart reply, turn skill.5.Room the intersection of tachycardia and urgent case can knock district of hitting in front of the heart, can make the room transfer to sinus rhythm of the heart rapidly sometimes. The person who has condition first chooses to use the direct current electricity to hit and reply the law skill, except for this apparatus person can select medicines for use to treat according to electrocardiogram type. If the fighting speed of room early. First-selected lidocaine, can also use rhythm of the heart to be flat, inject Procaine amide,etc.; If the turning back speed of room of peak, can select different third base Epinephrine or atropine or sulfic acid magnesium intravenous injection for use. (6) Treatment of cause of diseaseDo not have a specific treatment medicine to infect yet to the virus. The disease wants for the first time to try out virus thiazole, stop or interfere with medicine that poison duplicate and spread quinoline croak, steel alkanes gold amine, A candy afterbirth glucoside, ShengTing, interferon, ribonucleic acids immune Pan,etc., but curative effect is not definite. Traditional Chinese medicine such as big blue and green leaf, blue root of the board, honeysuckle, forsythia, rhizome of cyrtomium, Radix Astragali,etc. has certain inhibitory activity on some virus, can also try out. (7) Other:Root of red-rooted salvia injects the liquid 6- 8ml and adds 10% of the glucose axillary veins to instil, or every day 2- 4ml, intramuscular injection. There is blood circulation promoting silt, improve the cardiac muscle to circulate, promote the function that inflammation absorbs.

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