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慢性危重症治疗学
$70.10
书中所述不仅参考了国内外Z新的研究进展,还结合临床实践中大家容易遇到的问题予以细致阐释。对于慢性危重症相关康复设备的使用与维护、耗材的使用与管理等方面书中也做了详细介绍。
本书是我国部有关慢性危重症治疗的专业著作。作者从临床实践出发,结合国内外慢性危重症相关的Z新进展,以实用为原则,以治疗康复为目标,切合临床实际,编写而成。全书共 28 章,主题得当,重点突出,全面介绍了慢性危重症的监测、治疗与康复的相关内容,不仅介绍了慢性危重症的流行病学、发病机制、病理生理、诊断治疗等基础知识,还对各种常见的慢性危重症进行了系统阐述,并且对慢性危重症的康复治疗、HDU 病房建设、护理及伦理学问题进行了介绍。本书非常适合广大从事重症医学科、康复科、神经科、老年科等领域的医务工作者借鉴参考,也可供医学专科生、本科生、研究生、进修生作为重症医学、重症康复的选修教材和辅导读物。
尤荣开教授,主任医师,硕士研究生导师。历任浙江省温州市中心医院重症医学科主任、浙江大学明州医院重症医学科主任,兼任华东地区危重病医学专家委员会常委、浙江省重症医学分会委员、温州市重症康复医学专业委员会主任。1997 年开始从事重症医学,长期从事临床一线医疗工作,积累了丰富的临床经验。主要研究方向为神经重症、慢性危重症康复、人工气道建立与维护、昏迷复苏。承担、省级、市级医学继续教育项目多项,各级研究课题5 项。主编《人工气道建立与维护》《神经科危重症监测治疗学》《常见危重综合征救治》《常用急救仪器设备使用与维护》《常见临床脑病救治》等 5 部专著,参编《现代肠内和肠外营养的临床实践》《外科大查房——病例选录》,在国内、外期刊发表论文 50 余篇。 潘剑敏长期任职于康复医院重症医学科,从事临床一线医疗工作近 30 年,熟练掌握重症医学常见疾病的诊断与治疗,在重症肺炎、脓毒症、多器官功能不全综合征、各种休克、多发性创伤、呼吸衰竭、心力衰竭等方面具有丰富的抢救经验,对各种重大、疑难、复杂麻醉手术的围术期处理及监护治疗、急救具有丰富的临床经验。擅长各种生命支持手段,如呼吸支持技术、血流动力学监测、心血管活性药物使用、除颤仪使用、中心静脉及动脉置管、各种监测系统建立、危重症营养治疗技术等。主要研究方向为慢性危重症治疗与康复、人工气道建立与维护、昏迷复苏。
第 1 章 慢性危重症概述一、急性危重症结局二、慢性危重症定义三、慢性危重症带来影响四、慢性危重症患者治疗场所五、慢性危重症伦理思考第 2 章 慢性危重症流行病学一、美国慢性危重症流行病学二、日本慢性危重症流行病学三、中国慢性危重症流行病学第 3 章 慢性危重症病理生理一、持续炎症反应和免疫抑制学说二、损伤相关分子模式学说三、应激反应内分泌失调学说第 4 章 慢性危重症诊断标准和临床特征一、慢性危重症 RTI 诊断标准二、慢性危重症其他诊断标准三、慢性危重症临床特征四、结论第 5 章 危重症神经内分泌病理学一、生长激素轴改变二、垂体 - 甲状腺轴改变三、垂体 - 肾上腺皮质轴改变四、神经内分泌激素干预治疗研究结果五、结论第 6 章 慢性危重症神经肌肉骨骼疾病一、ICU 获得性肌无力二、危重症肌病 三、危重症多发性周围神经病四、慢性危重症肌少症五、骨质疏松症六、慢性危重症代谢性骨病第 7 章 慢性意识障碍诊断与治疗 一、概述二、病因与病理生理学三、pDoC 临床行为评估四、pDoC 神经影像学评估五、pDoC 神经电生理评估六、pDoC 治疗七、预后与伦理学八、结论第 8 章 慢性危重症认知和心理障碍一、慢性危重症认知障碍二、危重症后创伤后应激障碍三、危重症后抑郁症第 9 章 谵妄一、定义二、流行病学三、谵妄病因四、谵妄病理生理学五、谵妄临床表现和分类六、谵妄筛查、诊断与鉴别诊断七、谵妄预防八、谵妄治疗九、结论第 10 章 慢性危重症患者睡眠障碍一、基本概念二、影响慢性危重症患者睡眠障碍因素三、睡眠障碍对慢性危重症患者的影响四、慢性危重症患者睡眠障碍评估五、慢性危重症患者睡眠障碍应对策略六、结论第 11 章 慢性危重症患者关节挛缩与康复一、流行病学二、挛缩病因三、挛缩发病机制四、挛缩分类五、骨质疏松症六、慢性危重症代谢性骨病第 7 章 慢性意识障碍诊断与治疗一、概述二、病因与病理生理学三、pDoC 临床行为评估四、pDoC 神经影像学评估五、pDoC 神经电生理评估六、pDoC 治疗七、预后与伦理学八、结论第 8 章 慢性危重症认知和心理障碍一、慢性危重症认知障碍二、危重症后创伤后应激障碍 三、危重症后抑郁症第 9 章 谵 妄一、定义二、流行病学三、谵妄病因四、谵妄病理生理学五、谵妄临床表现和分类六、谵妄筛查、诊断与鉴别诊断七、谵妄预防八、谵妄治疗九、结论第 10 章 慢性危重症患者睡眠障碍一、基本概念二、影响慢性危重症患者睡眠障碍因素三、睡眠障碍对慢性危重症患者的影响四、慢性危重症患者睡眠障碍评估五、慢性危重症患者睡眠障碍应对策略六、结论第 11 章 慢性危重症患者关节挛缩与康复一、流行病学二、挛缩病因三、挛缩发病机制四、挛缩分类五、挛缩预防六、挛缩治疗七、结论第 12 章 慢性危重症长期机械通气一、LTMV 定义 二、LTMV 预后 三、LTMV 病因 四、呼吸机依赖五、LTMV 相关问题六、LTMV 通气设备七、LTMV 患者监测八、LTMV 气道管理九、LTMV 分泌物清除十、伦理问题和临终关怀十一、结论第 13 章 呼吸机相关性膈肌功能障碍一、VIDD 病因二、VIDD 病理生理三、VIDD 评估与诊断四、VIDD 防治策略五、结论第 14 章 气管插管拔管后吞咽障碍一、PED 发病情况 二、PED 危险因素三、PED 病理生理学四、PED 筛查评估五、PED 康复治疗六、结论第 15 章 慢性危重症气道维护常用技术一、慢性危重症通气管使用规范二、面罩使用规范三、呼吸球囊使用规范四、气管导管套囊压力维护规范五、慢性危重症人工鼻使用规范六、慢性危重症人工气道湿化规范七、慢性危重症人工气道雾化规范八、慢性危重症人工气道吸痰规范九、振动排痰机使用规范十、无创经气道咳痰机使用规范十一、慢性危重症人工气道拔除规范十二、慢性危重症气管切开后气道狭窄诊断与处理第 16 章 慢性危重症吸入性肺炎诊治一、AP 概念二、流行病学三、AP 的危险因素四、AP 病理生理五、临床表现六、实验室检查七、影像学检查八、诊断和鉴别诊断九、AP 治疗十、预防十一、结论第 17 章 慢性危重症多重耐药菌感染一、多重耐药菌定义二、慢性危重症多重耐药菌感染流行病学 三、慢性危重症患者多重耐药菌感染危险因素四、MDRO 感染监测五、慢性危重症患者多重耐药菌感染预防六、多重耐药菌感染治疗策略七、结论第 18 章 慢性危重症静脉血栓栓塞症预防一、流行病学二、DVT 危险因素三、DVT 发病机制四、临床表现五、VTE 风险评估六、VTE 预防七、结论附:重症医学科静脉血栓栓塞症预防核查单第 19 章 慢性危重症胃肠道功能维护一、胃肠道功能障碍概念 296 二、胃肠道屏障功能三、慢性危重症胃肠道功能衰竭病因与机制四、慢性危重症患者胃肠道功能障碍五、慢性危重症患者胃肠道功能障碍临床表现六、慢性危重症胃肠道功能评估七、慢性危重症胃肠功能评分与分级八、慢性危重症胃肠道功能维护九、结论第 20 章 慢性危重症营养支持一、慢性危重症代谢变化二、慢性危重症患者营养评估三、慢性危重症患者营养支持策略四、慢性危重症患者常用肠内外营养制剂五、慢性危重症其他补充营养制剂六、慢性危重症肠内营养支持并发症及处理七、结论第 21 章 危重症维生素 D 缺乏症一、维生素 D 合成与调节二、维生素 D 与危重症关系三、危重症维生素 D 缺乏易患因素四、危重症维生素 D 缺乏诊断五、危重症维生素 D 缺乏预防与治疗六、结论第 22 章 重症康复一、重症康复定义二、重症康复发展简史三、重症康复适应证与禁忌证四、重症康复技术五、重症康复目标及流程六、重症康复治疗时常见问题及对策七、重症康复安全性和有效性研究八、结论第 23 章 重症康复病房设置与管理一、病房建设二、HDU 设备配置 三、HDU 收治适应证和非适应证四、HDU 管理五、设置 HDU 获益六、结论第 24 章 重症康复常用器材一、电动起立康复床二、体外膈肌起搏器三、吞咽功能障碍治疗仪四、智能运动训练仪使用与维护五、上下肢主被动训练仪使用与维护六、脑电仿生电刺激仪使用与维护七、低频脉冲痉挛肌治疗仪使用与维护八、膀胱扫描仪使用与维护第 25 章 经颅磁刺激治疗一、经颅磁刺激仪结构与工作原理二、TMS 仪分类三、TMS 作用机制四、TMS 适应证和禁忌证五、经颅磁治疗仪的使用与维护六、TMS 的临床应用及疗效 七、TMS 优点及安全性评价八、结论第 26 章 慢性危重症高压氧治疗一、基本概念二、高压氧治疗慢性危重症机制三、高压氧治疗临床应用四、治疗慢性危重症高压氧设施要求和设备选择五、高压氧治疗慢性危重症方案六、高压氧治疗慢性危重症实施与护理七、高压氧治疗慢性危重症几个常见问题八、重症高压氧治疗疗效九、结论第 27 章 慢性危重症护理一、慢性危重症病情观察二、慢性危重症患者约束带使用规范三、气管切开导管更换操作规范四、气管切开内套管更换操作规范五、经口气管插管患者口腔护理规范六、气管切开切口换药规范七、慢性危重症患者会阴护理规范八、慢性危重症患者营养支持护理九、慢性危重症气管切开患者高压氧治疗的护理十、慢性危重症患者压疮的预防与护理十一、慢性危重症患者及家属的沟通第 28 章 慢性危重症患者伦理学一、生命终末期定义与判断二、生命终末期医疗现状三、终末期患者治疗抉择原则四、限制或撤离生命支持实施方法 五、结论
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