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href="/xywy/mjjt/">名家健坛</a></span></h1> <div id="i2i2jyu4k" class="pa_0_5_0_10"> <h1 class="Content_title" id="hh"> <span id="a" style="">远离猝死杀手：心梗</span> </h1> <script>/*jQuery('#hh').width(jQuery('#a').width());*/</script> <div id="i2i2jyu4k" class="Remark"> <span>2017年02月15日 09:04 | 作者:刘旭 | 来源：<a target="_blank">人民政协网</a></span> <span id="i2i2jyu4k" class="fr"> <div id="i2i2jyu4k" class="bdsharebuttonbox"><a href="#" class="bds_more" data-cmd="more"></a><a href="#" class="bds_qzone" data-cmd="qzone" title="分享到QQ空间"></a><a href="#" class="bds_tsina" data-cmd="tsina" title="分享到新浪微博"></a><a href="#" class="bds_tqq" data-cmd="tqq" title="分享到腾讯微博"></a><a href="#" class="bds_renren" data-cmd="renren" title="分享到人人网"></a><a href="#" class="bds_weixin" data-cmd="weixin" title="分享到微信"></a></div> <script>window._bd_share_config={"common":{"bdSnsKey":{},"bdText":"","bdMini":"2","bdMiniList":false,"bdPic":"","bdStyle":"0","bdSize":"16"},"share":{}};with(document)0[(getElementsByTagName('head')[0]||body).appendChild(createElement('script')).src='http://bdimg.share.baidu.com/static/api/js/share.js?v=89860593.js?cdnversion='+~(-new Date()/36e5)];</script> </span><span id="i2i2jyu4k" class="fr">分享到：<img src="/images/fx.jpg" /> </span> </div> <div id="i2i2jyu4k" class="text_box"> <p align="center"> <p style="text-align:center"><a href="/upload/resources/image/2017/02/15/1565105.jpg" target="_blank"><img src="/upload/resources/image/2017/02/15/1565105_600x600.jpg" title="C2017-02-15zx601_P_1_19_428_1077_962" alt="C2017-02-15zx601_P_1_19_428_1077_962" suffix="jpg"/></a></p><div class="i2i2jyu4k" id="content" style="text-indent: 2em; text-align: left;"><p style="text-indent: 2em; text-align: left;">2月8日晚，途牛旅游网预订中心副总经理李波因心肌梗死离世，年仅44岁。而仅仅4个月前，春雨医生的创始人张锐同样因为心肌梗死去世，也同样年仅44岁。年轻创业者们，“出师未捷身先死”实在令人唏嘘。我国心梗呈年轻化趋势，冠心病和脑血管病合成心脑血管病已经超越肿瘤成为我国第一致死病因。</p><p style="text-indent: 2em; text-align: left;">心肌梗死是比较常见的一种心血管疾病，很多人一劳累就会觉得心脏不舒服，可是人们普遍对于这一疾病的认识不是很深，容易忽视或者夸大了病情。</p><p style="text-indent: 2em; text-align: left;">心肌梗死的成因是部分心肌的血液循环突然全部中断，心肌因无法得到足够氧气而导致的损伤。心肌梗死90%以上是由于冠状动脉粥样硬化病变基础上血栓形成而引起的，所以预防时应控制导致动脉粥样硬化的因素，如高血压、高血脂等。</p><p style="text-indent: 2em; text-align: left;"><strong>心梗的诱因</strong></p><p style="text-indent: 2em; text-align: left;">过劳：过重的长时间劳动，尤其是负重登楼、过度体育活动、连续紧张劳累等，都可使心脏负担加重或诱发斑块破裂，导致急性心肌梗死。</p><p style="text-indent: 2em; text-align: left;">便秘：临床上，因便秘时用力屏气而导致心肌梗死的老年人并不少见，必须引起老年人足够的重视，日常要保持大便通畅。</p><p style="text-indent: 2em; text-align: left;">寒冷刺激：突然的寒冷刺激可能诱发急性心肌梗死，冬春寒冷季节是急性心肌梗死发病较高的原因之一。</p><p style="text-indent: 2em; text-align: left;">暴饮暴食：不少心肌梗死病例发生于暴饮暴食之后。进食大量含高脂肪高热量的食物后，血脂浓度突然升高，导致血黏稠度增加，血小板聚集性增高。在冠状动脉狭窄的基础上形成血栓，引起急性心肌梗死。</p><p style="text-indent: 2em; text-align: left;">激动：激动、紧张、愤怒等激烈的情绪变化容易诱发心肌梗死。</p><p style="text-indent: 2em; text-align: left;">吸烟、大量饮酒：吸烟和大量饮酒可通过诱发冠状动脉痉挛及心肌耗氧量增加而诱发急性心肌梗死。</p><p style="text-indent: 2em; text-align: left;"><strong>心梗早期症状</strong></p><p style="text-indent: 2em; text-align: left;">心肌梗死病人约70%有先兆症状，多在发病前1周，少数病人甚至提前数周出现。约40%的病人发生于梗死前1～2天。</p><p style="text-indent: 2em; text-align: left;">心肌梗死常见症状有：心绞痛疼痛时可能伴有大汗、恶心、呕吐、虚弱、晕眩、呼吸困难、心悸、心律失常、有时丧失知觉等，常称之为梗死前状态；在近期内，原有的心绞痛性质改变（加频、变剧、持续时间延长），或多在安静休息时发作，含服硝酸甘油疗效差；以往身体健康，突然出现憋闷、乏力、运动时心慌气短等，并且进行性加重。这时就要警惕了，可能是心肌梗死的前兆；中老年患者突然出现急性左心衰竭、心源性休克、严重心律失常，并且不能用其他原因解释者。</p><p style="text-indent: 2em; text-align: left;"><strong>心肌梗死如何识别</strong></p><p style="text-indent: 2em; text-align: left;">严重的胸痛或腹痛：通常位于胸骨中上段，不典型患者疼痛或不适感上至咽部，下至上腹部，向左肩、左前臂尺侧或下颌放射，胸痛呈压榨感、紧缩感、窒息感，或胸憋胸闷，时间超过20分钟。</p><p style="text-indent: 2em; text-align: left;">救心丸不能缓解：与心绞痛不同，若是心梗，通过休息和含硝酸甘油、消心痛、或速效救心丸是不能缓解的。</p><p style="text-indent: 2em; text-align: left;">烦躁不安：心梗发生前后患者可有烦躁、大汗、恐惧或有濒死感等症状时，应高度怀疑急性心肌梗死发作，特别需要注意的是，患者还可能出现恶心、呕吐等胃肠道症状。</p><p style="text-indent: 2em; text-align: left;">昏迷：如果心脏一旦没有有效跳动，患者会出现气短、黑其、晕厥或短暂意识丧失。</p><p style="text-indent: 2em; text-align: left;">如果怀疑，一定要做进一步检查，应及时送医，听从医务人员指挥，配合诊治。</p><p style="text-indent: 2em; text-align: left;"><strong>心梗急救：立即平躺</strong></p><p style="text-indent: 2em; text-align: left;">急性心肌梗死最有效的治疗是通过溶栓、放支架等方式的再灌注治疗，让心脏重获血液供应。</p><p style="text-indent: 2em; text-align: left;">如果家人发生心梗，一定不要帮倒忙，要让病人平躺休息，在何处发病都要立即平躺。有些心梗患者发病时会因为胸痛倒地，这时很多人会把患者扶起来，喂两口水拍拍后背，这样做很要命。</p><p style="text-indent: 2em; text-align: left;">因为心脏每分钟都在不停地做功，所以它是全身需要供血最多的地方，而平卧时身体供应给心脏的血液是最多的。冠状动脉本身就缺血，站和坐都会使心脏缺血更加严重。因此疑似心梗发作第一时间原地平躺，降低心脏负荷。</p><p style="text-indent: 2em; text-align: left;">同时，立即拨打120急救。有这样一个统计数字，心?；颊弑饶宰渲谢颊叻⒉『笃骄淼揭皆?小时，这是因为脑卒中症状明显，能看到肢体不能动、口歪眼斜的症状。而心梗由于症状不典型、疼痛剧烈但可行动，所以很多人却都是选择忍着。其中，70%的患者不是急救车送来的，在心内科门急诊也经常见到很多患者是坐公交、打车、骑车来的。曾有一位60岁男患者，胸痛难忍开车来医院，好不容易开到了医院，人却死在了车里，危险性可想而知。时间就是生命，越快来医院越好，虽然可能是“狼来了”白跑一趟，但也总比没命了强。</p><p style="text-indent: 2em; text-align: left;">（作者系上海市胸科医院主任医师）</p></div> </div> <p class="Editor">编辑：赵彦 </p> <div id="i2i2jyu4k" class="Paging"> </div> <p class="Keyword">关键词：猝死心梗诱因症状心梗急救</p> <h1 class="pv_title_2 mt_15"><a href="/index.shtml" target="_blank" class="more mtb_14">更多</a><span id="i2i2jyu4k" class="t" id="a3"><a href="/index.shtml"><img src="/images/xg_t1.jpg" /></a></span></h1> <div id="i2i2jyu4k" class="pa_0_5_0_10"> <ul class="Related_ul bh_150"> <li><a target="_blank" href="/c/2015-05-25/505234.shtml">心脏猝死到底是什么引起的</a></li> <li><a target="_blank" href="/c/2014-09-04/372738.shtml">去哪儿网员工猝死重压之下的白领如何“保命”?</a></li> <li><a target="_blank" href="/c/2017-06-30/1626330.shtml">26岁医生发文"还活着真好" 2个月后通宵加班猝死</a></li> <li><a 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