目錄 catalogue 前言 Introduction 什麼是心導管檢查? What is Cardiac Catheterization? 心導管檢查的適應症 Why do I need a cardiac catheterization? 心導管檢查及治療 What is card

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1 敬祝您身體健康平安吉祥 Wish you Healthy & eaceful 佛教慈濟綜合醫院 Buddhist Tzu Chi General Hospital 各院區健康諮詢專線 Health consultancy of Buddhist Tzu-Chi Hospital: 花蓮慈濟醫院 Hualien Tzu Chi Hospital:(03) 玉里慈濟醫院 Yuli Tzu Chi Hospital:(03) 關山慈濟醫院 Kuanshan Tzu Chi Hospital:(089) 台北慈濟醫院 Taipei Tzu Chi Hospital:(02) 台中慈濟醫院 Taichung Tzu Chi Hospital:(04) 大林慈濟醫院 Dalin Tzu Chi Hospital:(05) 大林慈濟醫院附設斗六門診部 Douliou Outpatient Department of Dalin TZU Chi Hospital : (05) 網址 :Web site: 大林慈院修訂認識心導管檢查 Cardiac Catheterization E8R 中英文

2 目錄 catalogue 前言 Introduction 什麼是心導管檢查? What is Cardiac Catheterization? 心導管檢查的適應症 Why do I need a cardiac catheterization? 心導管檢查及治療 What is cardiac catheterization? 心導管檢查前 Before a Cardiac Catheterization 7 8 檢查中 8 What happens during the procedure? 檢查後 10 What happens after the procedure? 日常保健 Daily care 13

前言 Introduction 心導管檢查是近二十多年來醫學界最重要的突破之一, 它是一種檢查也是一種治療, 目前已成功治療很多冠狀動脈心臟疾病患者, 並有良好的預後 Cardiac Catheterization is a b r e a k t h r o u g h i n m o d e r n medicine.

3 前言 Introduction 心導管檢查是近二十多年來醫學界最重要的突破之一, 它是一種檢查也是一種治療, 目前已成功治療很多冠狀動脈心臟疾病患者, 並有良好的預後 Cardiac Catheterization is a b r e a k t h r o u g h i n m o d e r n medicine. It is a diagnose tool and also a treatment method. It has been used to successfully treat patients with coronary artery diseases and the prognosis is favorable. For examination:a catheter is a thin flexible tube and is X-ray impermeable. Under regional anesthesia, the tube is inserted into a blood vessel in your arm or leg and guided to your heart (Fig.1). 圖一 : 心導管置入處 Catheter entry site 前臂 Forearm 手腕 Wrist 鼠蹊部 Groin 什麼是心導管檢查 What is Cardiac Catheterization? 它是一條長又富有彈性且具 X 光不透性的導管經由下肢股動脈或上肢橈動脈插入, 並在局部麻醉下, 順著血管一直到心臟所進行的一種檢查 ( 如圖一 ) 6 7

4 心導管檢查的適應症 Why do I need a cardiac catheterization? 1. 確立診斷 Confirm a diagnosis 2. 測量心臟的壓力和血中的含氧量, 評估是否適合開刀 Examine pressure within the heart as well as how much oxygen is in the blood and d e t e r m i n e t h e n e e d f o r further treatment. 3. 評估冠狀動脈狹窄的程度並做治療 Evaluate the narrowing of the coronary artery and undergo treatment 4. 評估心臟瓣膜疾病的嚴重度 Evaluate the heart valve function. 心導管檢查及治療 What is cardiac catheterization? 1. 導管進入血管中, 注入顯影劑, 檢查心臟是否有異常 For treatment:a catheter is inserted into a blood vessel, the dye is injected and the heart function will be examined. 2. 如果冠狀動脈狹窄的部分, 超過 60-70% 的正常管徑, 則會將氣球導管擴張, 利用壓力將狹窄部分撐開, 增加血流量 ( 如圖二 ) If the coronary artery gets narrowed by more than 60-70%, the balloon on the tip of the catheter is then inflated to enlarge the narrowing in the artery a n d t o i n c r e a s e b l o o d flow(fig.2). 8 9

3. 經醫師評估後, 必要時則放入血管支架, 使支架完全稱開血管內壁, 並永久留在血管內, 以保持血管擴張 ( 如圖三 ) A f t e r e v a l u a t i o n, y o u r physician may use a metal stent to brace the artery open and the stent

圖二 : 氣球擴張術 Balloon Angioplasty 圖三 : 血管支架置放術 Stenting 心導管檢查前 Before a Cardiac Catheterization 當決定接受心導管前, 我們會為您作一系列的檢查, 如 : 血液檢查心電圖檢查等 Your physician will order tests,

5 3. 經醫師評估後, 必要時則放入血管支架, 使支架完全稱開血管內壁, 並永久留在血管內, 以保持血管擴張 ( 如圖三 ) A f t e r e v a l u a t i o n, y o u r physician may use a metal stent to brace the artery open and the stent remains in place to support the walls of your artery(fig.3). 圖二 : 氣球擴張術 Balloon Angioplasty 圖三 : 血管支架置放術 Stenting 心導管檢查前 Before a Cardiac Catheterization 當決定接受心導管前, 我們會為您作一系列的檢查, 如 : 血液檢查心電圖檢查等 Your physician will order tests, including blood tests, electrocardiogram etc., if you determine to have a Cardiac Catheterization. 1. 前一天您應準備的工作如下 : reparation you can do the day before the procedure: 填寫同意書 Fill out the inform consent. 晚上 12 點後禁食 Cannot eat or drink over 4 hours. 保持心情輕鬆避免過度緊張 Remain relaxed and avoid overstrain

6 2. 當天護理人員會為您準備的工作 : reparation nurses will do before the procedure: 協助刮除下腹部或手腕處的毛髮 ( 檢查處 ) Clean your skin and shave any hair in the immediate area (arm and groin). 手腕或足背處予劃脈搏作記號, 以便觀察脈膊跳動的情形 Mark the placement of pulse to observe pulse rhythm. 必要時會先為您打上點滴 Give you IV injection if necessary. 檢查中 What happens during the procedure? 1. 進入檢查室後, 會為您裝上心電圖監視器並施以局部麻醉, 此時您的意識是清醒的, 如有不適情形隨時告訴您的醫師 As you enter the procedure room, you will be mildly sedative and be attached to an EKG monitor. You will remain conscious during the procedure, so when you feel discomfort do tell your doctor immediately. 2. 當導管放入血管中, 並不會有異樣感覺, 在進行中常需要您配合做咳嗽的動作 When the catheter inserts into the artery, you won t feel it. You may be asked to cough during the procedure. 3. 心導管檢查一次的時間約 1-2 小時即可完成 The procedure usually takes 1-2 hours. 4. 當血管阻塞嚴重時, 醫師會向您的家屬解釋, 並說明必須做的醫療處置, 如氣球擴張術或置放支架, 使阻塞的血管達到擴張及通暢 12 13

7 When your doctor found blockages in your blood vessel, your health care providers will explain to your family the necessary medical treatment such as angioplasty or stenting. W i t h a s u c c e s s f u l angioplasty, the blockage will be pushed outward against the artery walls and the blood flow is restored. 檢查後 What happens after the procedure? 1. 醫護人員會密切監測您的血壓心跳及傷口出血情形, 如有不適應立即通知醫護人員 Health professionals will closely monitor your blood pressure, heart rate and incision bleeding; during recovery, be sure to report anything that feels abnormal or not right to your health care providers. 2. 當傷口在手腕處會以紗布覆蓋止血帶加壓止血約 3-6 小時 ( 如圖四 ); 若傷口在鼠蹊部則以 2 公斤砂袋加壓止血約 6 小時 If the catheter entry site is in your arm, the incision will be bandaged for 3-6 hours (Fig.4). If the catheter insertion site is in your groin area, the incision will be closed with gauze with applied pressure for 6 hours. 圖四手部加壓止血 To apply pressure aroun the wrist area to stop bleeding

8 3. 傷口在鼠蹊部時, 應平躺 6-8 小時, 檢查的肢體盡量伸直勿彎曲, 避免出血 When the catheter entry site is in your groin area, you have to lie in the bed for 6-8 hours and keep your legs straight to prevent bleeding. 4. 觀察檢查的肢體血液循環, 是否有冰冷及麻木感的情形發生, 如果有此情形則應立即通知您的醫護人員 Be sure to let your health care providers know if you feel limb numbness, cold or any discomfort. 5. 通常手術後 1-2 天即可回家, 回家前醫師會再為您做一次詳細的解說, 並提醒您應該注意的事項, 若有問題隨時可提出討論 Depend on your recovery, your can expect your hospital stay after the procedure to last from 1 to 2 days. When you leave the hospital, you will be given specific instruction for follow-up care or things you should pay attention to. Be sure to ask your doctor any question that s on your mind. 日常保健 Daily care 1. 按時服藥並回門診定期追蹤 Take your medicine and have the follow-up visits on time 2. 選擇低油低鹽低糖的飲食 Choose to have Low fat, low salt and low sugar diet. 3. 放鬆心情避免壓力過大 Remain relaxed and avoid overstrain. 4. 戒煙戒酒 Smoking and drinking cessation. 5. 控制體重 Weight control

week and a minimum of 30 minutes for each

9 6. 避免劇烈運動及提重物, 以減少心臟負荷 Avoid intense exercise and heavy lifting. 7. 運動的時間及項目 : 一週至少 3 次一次至少 30 分鐘 Do appropriate exercise at least 3 times a week and a minimum of 30 minutes for each time. 運動項目以散步騎腳踏車游泳太極拳外丹功等有氧運動為主 Aerobic exercise, such as walking, bicycling, swimming, Tai chi chuan, and Waidangong, is recommended after the procedure. 8. 若有不適及疑問, 隨時與我們聯絡, 我們隨時為您解答 lease feel free to contact us for any further consultation

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