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1、个人资料整理仅限学习使用1/9 医学各大系统重点精华总结！诊断公式+辅助检查+治疗原则消化系统疾病诊断公式共同症状：腹痛、腹泻、恶心、呕吐、包块1.急、慢性胃炎=饮食不洁或刺激物上腹痛、腹胀、恶心呕吐2.胃食管反流病=反酸+胸骨后烧灼感+胃镜检查食管下段红色条样糜烂带烧心、反酸、返食）3.消化性溃疡病胃溃疡=慢性规律性上腹痛饱餐后痛）呕血黑便十二指肠溃疡=饥饿时痛 餐后 4小时以上）或夜间痛呕血黑便消化性溃疡穿孔=突发剧烈腹痛 腹膜炎体征）X线膈下有游离气体4.食管胃底静脉曲张=上消化道大出血既往肝病史5.细菌性痢疾=不洁饮食腹痛粘液脓血便里急后重6.溃疡性结肠炎=左下腹痛粘液脓血便便意、便后
2、缓解）抗生素无效治疗：柳氮磺吡啶SASP）7.急性胰腺炎 水肿型）=暴饮暴食/慢性胆道病史持续上腹疼痛弯腰疼痛减轻淀粉酶检测急性胰腺炎 出血坏死型）=水肿型症状腰腹部或脐周紫斑腹穿洗肉水样液体血糖高血钙低出血坏死型：血尿淀粉酶值不一定高,有时反而会下降.确诊时选CT 一周内测血淀粉酶,超过一周测脂肪酶8.幽门梗阻=呕吐宿食振水音9.肝硬化=肝炎病史门脉高压脾大腹水蜘蛛痣）超声肝脏缩小）10.胆囊炎=阵发性右上腹绞痛莫非征阳性恶心呕吐11.胆石症=阵发性右上腹绞痛莫非征阳性B超强回声光团、声影12.急性梗阻性化脓性胆管炎=下柯三联征 腹痛寒颤高热黄疸）休克表现精神症状如神情淡漠、昏迷）五联征13
3、.急腹症1）阑尾炎=转移性右下腹痛麦氏点压痛胀痛、闷痛）WBC 升高2）肠梗阻：腹痛吐胀闭X线 香蕉/液平）病因：机械性和动力性血运：单纯性和绞窄性程度：完全性和不完全性部位：高位和低位3）消化道穿孔=溃疡病史突发上腹部剧痛腹膜刺激征膈下游离气体4）异位妊娠=阴道出血停经史下腹剧痛宫颈举痛）绒毛膜促性腺激素5）卵巢囊肿蒂扭转=体位变化突发腹痛囊性肿物6）急性盆腔炎=刮宫手术史白带异常下腹痛下腹剧痛宫颈举痛）脓性分泌物14.消化系统肿瘤1）胃癌=老年人黑便龛影慢性溃疡疼痛规律改变上腹痛腹部包块消瘦左锁骨上淋巴结肿大2）食管癌=进行性吞咽困难中晚期）胸骨后烧灼样疼痛早期）进食哽咽感早期）3）肝癌：
4、肝炎病史肝区疼痛AFP升高肝大质硬腹水黄疸B超占位4）直肠癌=直肠刺激症状指诊带血脓血便消瘦大便变形5）胰腺癌 胰头癌、壶腹周围癌）=老年人无痛进行性加重黄疸陶土色大便皮肤瘙痒6）结肠癌：老年人消瘦排便习惯改变CEA 腹部肿块15.肛门、直肠良性病变1）内痔=无痛性血便便带鲜血静脉样团块2）外痔=肛门疼痛便鲜血肛门口触痛肿物3）肛裂=便时便后肛门剧痛肛门裂口个人资料整理仅限学习使用2/9 16.腹部闭合性损伤肾损伤=腰部损伤血尿肝破裂=右腹部外伤腹膜刺激征移动性浊音脾破裂=左腹部外伤全腹痛腹腔内出血肠破裂=腹中部外伤腹膜刺激征穿刺淡黄色液体17.腹外疝 斜疝）=老年男性腹压增加右下腹肿物进入阴
5、囊消化系统疾病进一步检查1.胃镜、结肠镜、直肠镜2.消化道造影3.腹部 B超、CT 4.立位腹平片5.粪便：常规检查、隐血、培养和寄生虫检查6.HP 检测7.腹腔穿刺8.淋巴结活检或肝活检病例监测）9.实验室检查：1）血尿淀粉酶2）AFP、CEA、CA19-9 糖链抗原3）血尿常规检查、肝肾功能、电解质、血气分析等消化系统治疗原则一、一般治疗：注意休息,控制饮食/禁食,生活指导二、病因治疗1）溃疡：首选PPI 类抑酸药,可加用黏膜保护剂,如有幽门螺杆菌感染应行联合除菌治疗,常用三联疗法或四联疗法：PPI、胶体铋联合两种抗生素2）应用广谱抗生素抗感染治疗、抗休克3）梗阻/腹膜炎：禁食、胃肠减压4
6、）维持水电解质酸碱平衡三、对症治疗四、手术：切除或修补五、肿瘤：1）手术治疗 2）放疗化疗免疫治疗中医中药治疗呼吸系统疾病诊断公式1.急性上呼吸道感染=咽痛咳嗽发热2.肺炎1）大叶性肺炎=成人受凉高热咳铁锈色痰2）克雷伯杆菌肺炎=咳砖红色痰X线片空洞3）支原体肺炎=儿童刺激性干咳关节疼抗生素无效4）支气管肺炎=婴幼儿发热呼吸困难症状鼻翼扇动、三凹征阳性）5）金色葡萄球菌肺炎=高热胸痛脓血痰X线片状影3.结核病1）肺结核=青壮年咯血午后低热夜间盗汗抗生素治疗无明显疗效2）结核性胸膜炎=结核胸膜积液体征胸痛语颤消失叩诊实音/呼吸音消失）3）结核性心包炎=结核心包积液体征心前区痛呼吸困难上腹部闷胀下
7、肢浮肿）4）肠结核=结核腹部症状腹痛、腹泻、右下腹部肿块）5）结核性腹膜炎=结核腹部炎症腹痛、腹泻、腹壁柔韧感）6）肾结核=结核膀胱刺激征肾实质变薄并有破坏4.支气管扩张=童年有麻疹百日咳或支气管肺炎迁延不愈病史咳嗽脓痰咯血文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6
8、U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码
9、:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L
10、10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV
11、10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C
12、5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M
13、3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3
14、F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3个人资料整理仅限学习使用3/9 5.COPD=老年人 吸烟史）咳痰喘桶状胸肺功能检查,一秒率 FEV1/FVC%小于 70%6.肺脓肿=脓臭痰高热X线片/CT 显示液平7.肺癌=中、老年人痰中带血刺激性咳嗽消瘦X线毛刺8.肺心病=慢性肺部疾病病史心脏扩大演变顺序：慢支-肺气肿-肺心病9.支气管哮喘=阵发性或周期性喘息听诊哮鸣音过敏史10.呼吸衰竭=慢
15、性肺部疾病病史发绀血气分析指标I 型：PaO260mmHg PaCO2正常-重症肺炎诱发II型：PaO250mmHg-慢阻肺诱发11.胸部闭合性损伤1）张力性气胸=胸外伤史广泛皮下气肿握雪感）气管偏移叩诊鼓音呼吸音消失2）血胸=胸外伤史气管偏移叩诊浊音呼吸音减弱X线肋膈角消失,弧形高密度影3）肋骨骨折=胸外伤史骨擦音呼吸系统疾病检查工程1.胸部 X片、胸部CT 2.PPD、血沉3.痰培养药敏实验、痰找结核杆菌4.肺功能5.肝肾功能6.血气分析7.纤维支气管镜8.痰液脱落细胞检测9.淋巴结活检10.血常规、电解质呼吸系统疾病治疗原则1.一般治疗：休息,加强营养,预防感染/吸氧2.对症治疗/药物治
16、疗1）抗感染治疗：使用广谱抗生素或联合用药2）抗结核治疗：早期、适量、联合、规律、全程3）抗休克：扩容,使用血管活性药物4）控制咯血：垂体后叶素5）解热、止咳、平喘、祛痰6）纠正酸碱平衡失调3.肿瘤 肺癌）1）手术治疗2）放疗化疗免疫治疗中医中药治疗循环系统疾病诊断公式1.冠心病=胸骨后压窄性疼痛1）心绞痛=胸骨后压窄性疼痛30 分钟,3-5分钟/次,休息或口含硝酸甘油能缓解ECG：ST段水平下移30 分钟,休息或口含硝酸甘油不能缓解大汗淋漓濒死感ECG：ST段弓背向上抬高V1-6 广泛前壁心梗V1-3 前间壁心梗V3-5 局限前壁心梗V5-6 前侧壁心梗、aVF下壁心梗文档编码:CG3F9T
17、6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编
18、码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6
19、L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 Z
20、V10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6
21、C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10
22、M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG
23、3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W
24、3个人资料整理仅限学习使用4/9 I、aVL 高侧壁心梗心功能 Killip分级：用于评估急性心肌梗死患者地心功能状态I 级：无肺部啰音和第三心音II级：肺部有啰音,但啰音地范围小于1/2 肺野III级：肺部啰音地范围大于1/2 肺野 IV 级：心源性休克2.高血压病按患者地心血管危险绝对水平分层正常 140/90）1 级 140-159或 90-99 低于 160/100 2 级 160-179或 100-109 低于 180/110 3 级 180 或110危险程度分层低危：1 级.改善生活方式.中危：1 级+2 个因素；2 级不伴或低于2 个因素.药物治疗.高危：1-2 级+至少 3 个
25、因素,靶器官损害.规则药物治疗.极高危：3 级；1-2级+靶器官损害、有并发症.尽快强化治疗.3.心衰=左肺 循环）右体 循环）左心衰=咳粉红色泡沫样痰呼吸困难夜间不能平卧、端坐呼吸、活动后）右心衰=颈静脉怒张双下肢水肿肝大心功能分级I 级日常不受限II级活动轻度受限III级活动明显受限IV 级休息时出现症状左心衰右心衰=全心衰4.心律失常：1）房颤=心律绝对不等脉短绌心电图f 波第一心音强弱不等2）阵发性室上性心动过速=阵发性心慌突发突止ECG 无 P波,心率 160-250 次/分）3）阵发性室性心动过速=突发性心慌既往发作史ECG 连续 3 次以上地快速宽大畸形地QRS 波心室夺获/室性
26、融合波4）其他：见第三站心电图学部分5.心脏瓣膜病1）二尖瓣狭窄=呼吸困难 劳力性、阵发性、夜间、端坐呼吸、急性肺水肿）急性大量咯血、粉红色泡沫痰梨形心隆隆样杂音2）二尖瓣关闭不全=急性左心衰/慢性晚期出现左衰或全衰心尖部粗糙地全收缩期吹风样杂音,向腋下或左肩胛下角传导3）主动脉瓣狭窄=呼吸困难心绞痛晕厥喷射性杂音并向颈部传导4）主动脉瓣关闭不全=心悸心绞痛夜间阵发性呼吸困难AustinFliht杂音周围血管征 水冲脉、Mussctz 征、颈动脉波动明显、毛细血管搏动征、动脉枪击音及Durozicz征）主要瓣膜杂音出现时期开关瓣杂音性质二尖瓣狭窄舒张期开隆隆样二尖瓣关闭不全收缩期关吹风样主动脉
27、瓣狭窄收缩期开喷射样主动脉瓣关闭不全舒张期关叹气样6.休克体征=PBp脉搏细速四肢发凉1）失血性休休克体征出血2）心源性休克=休克体征左心衰心血管系统进一步检查文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3
28、文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S1
29、0S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J
30、6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD
31、5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6
32、U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码
33、:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L
34、10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3个人资料整理仅限学习使用5/9 1.心电图、动态心电图2.超声心动图3.胸部 X线4.眼底检查 高血压）、放射性核素5.心肌酶谱6.血气分析7.血常规、血脂、血糖、血钾、肝肾功能8.心导管9.冠脉造影10.心肌坏死标记物肌红蛋白、肌钙蛋白、肌酸激酶同工酶CK-MB）心血管系统治疗原则1.一般治疗：注意休息、改变生活方式如戒烟酒、低钠低脂饮食、适度运动）,检测,护理2.高血压：1）利尿剂、B受体阻滞剂、钙通道阻滞剂
35、、ACEI血管紧张素转换酶抑制剂）、血管紧张素 II受体阻滞剂2）控制合并症.如心衰、糖尿病、脑血管病、肾衰、冠心病3.冠心病：对症治疗：控制心律失常,改善心功能,心梗 II预防溶栓或介入治疗控制休克,纠正心衰抗凝及抗血小板药物治疗：阿司匹林、肝素4.房颤：药物复律,选用胺碘酮减慢心室率,选用西地兰5.心衰：利尿、ACEI、B受体阻滞剂、正性肌力药洋地黄类：地辛高、西地兰.非洋地黄类：多巴胺、M力农）、心脏起搏器6.瓣膜病：病因治疗、瓣膜置换等泌尿系统疾病诊断公式1.肾小球肾炎：眼睑/颜面部水肿青少年链球菌感染史C3下降血尿蛋白尿高血压2.尿路感染1）肾盂肾炎=女性腰痛发热脓尿、白细胞管型2）
36、慢性肾盂肾炎急性发作=尿路损伤史膀胱刺激征反复发作腰痛发热肾区叩击痛WBC 升高3）下尿路感染=已婚女性发热膀胱刺激征3.肾结石=活动后出现血尿腰部绞痛B超或 X线4.输尿管结石=活动后出现血尿腰部绞痛X线检查5.肾癌=老年人 无痛性）肉眼血尿6.肾衰=多年肾炎病史血尿蛋白尿高血压血肌酐代偿期 133、失代偿期442、衰竭期707、尿毒症期）升高7.前列腺增生=老年人尿频进行性排尿困难泌尿系统疾病进一步检查1.腹部 B超、平片2.血尿常规、血沉、肾功能、血气分析3.肾盂造影4.穿刺活检5.妇科检查6.血肌酐、肾小球滤过率7.肾功能文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV
37、10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C
38、5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M
39、3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3
40、F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3
41、文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S1
42、0S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J
43、6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3个人资料整理仅限学习使用6/9 8.放射
44、性核素肾图9.膀胱镜泌尿系统治疗原则1.一般治疗：注意休息、低钠/低蛋白饮食2.对症治疗1）抗感染2）利尿降压3）透析4）纠正水电解质酸碱失调3.外科治疗：手术切除或切开4.肿瘤 肾癌）5.血液透析治疗1.甲亢=心悸眼突 眼胀）情绪激动多汗甲状腺肿大检查：T3/T4/TSH 131I 甲状腺核素2.甲状腺肿瘤=甲状腺肿物 B超结节3.糖尿病=三多一少,血糖测定：空腹7.0,餐后 11.1,OGTT 1）1 型糖尿病=三多一少发病急青少年烂苹果味2）2 型糖尿病=中老年发病慢不易出现酮症酸中毒糖尿病酮症酸中毒和高渗区别：血糖指标以33.3 为界限检查：果糖胺、胰岛素释放实验、C肽释放实验、糖化血
45、红蛋白一般治疗：生活指导、注意饮食、体育运动、病情监测、预防并发症药物治疗：促泌剂,磺脲类-2 型非肥胖,饮食运动控制不理想双胍类-肥胖者胰岛素-1 型和 2 型并发症a 葡萄糖苷酶抑制剂-餐后血糖高血液系统疾病诊断公式1.白血病=发热出血倾向胸骨压痛全血细胞减少2.再生障碍性贫血=贫血貌出血倾向三系减少3.自身免疫性溶血性贫血=贫血貌 Coombs 抗人球蛋白实验）阳性脾大4.缺铁性贫血=血清铁下降贫血貌皮肤黏膜苍白）女性月经过多或消化系统肿瘤5.特发性血小板减少紫癜=女性出血倾向血小板降低小于 100-109）,红白细胞计数正常6.DIC=多部位出血 PT延长 3P 实验阳性血液系统疾病进
46、一步检查1.骨髓穿刺检查2.细胞形态学检查3.肝肾功能、腹部B超4.血常规血液系统疾病治疗一般治疗：休息,控制感染,选用广谱抗生素白血病：化疗骨髓移植化疗：急性白血病,急淋-DVLP方案柔红霉素、长春新碱、左旋门冬酰胺酶、泼尼松）急非淋-DA 方案柔红霉素、阿糖胞苷）早幼粒-维甲酸文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7
47、J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 H
48、D5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T
49、6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编
50、码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6L10W3文档编码:CG3F9T6U10M3 HD5X6C5G7J6 ZV10S10S6