general treatment
Including the following aspects: (1) Early and reasonable bed rest is extremely important, which can repair the myocardium with inflammatory lesions as soon as possible and prevent the disease from getting worse. Generally, patients with myocarditis need to stay in bed for 3-4 weeks after hypothermia, and those with heart failure or heart enlargement need to rest for 0.5- 1 year, or after the heart size returns to normal and the ESR is normal. (2) The most common cause of prevention and treatment of myocarditis is upper respiratory tract infection, so it is necessary to prevent colds and viruses from invading the body. Because virus infection often coexists with bacterial infection or occurs one after another, and bacterial infection can often make the virus active, reduce the body's resistance and aggravate heart damage, so it is necessary to control bacterial infection in time through appropriate application of antibiotics. For some susceptible patients, such as recurrent tonsillitis, tonsillectomy can be performed when necessary to remove the inducement and/or inject transfer factor and gamma globulin to enhance the body's resistance and prevent recurrence. (3) Promoting myocardial repair Patients with myocarditis can inhale human oxygen and apply some drugs to improve myocardial metabolism, so as to promote myocardial repair, prevent the further development of the disease and reduce the occurrence of complications. Commonly used drugs in clinic are: ① high-dose vitamin C. Patients with myocarditis can take 200 ~ 500mg of vitamin C orally three times a day, and they can also take intravenous injection of 5 ~ 10g in batches. 10 ~ 14 days is a course of treatment. Vitamin C has antiviral effect, which can increase coronary blood flow, promote myocardial metabolism, increase myocardial utilization of glucose, and is beneficial to myocardial repair. ② Energy polarized liquid. The components of energy polarization liquid include adenosine triphosphate (ATP), coenzyme A, potassium chloride, insulin, glucose, etc., which can provide energy for myocardium and promote myocardial metabolism, thus accelerating the repair process. Generally, 10 ~ 14 days is a course of treatment, and intravenous drip can be repeated. ③ Coenzyme Q 10, inosine, etc. The role of these drugs is to improve myocardial metabolism, which is very beneficial to myocardial repair. Clinically, it is often given orally to patients with myocarditis to cooperate with treatment.
1, treatment of primary disease: very critical. People infected with the virus can take the antiviral drug amantadine 200 mg; One day; Maringuanidine 0. 1g, taken orally, three times a day. If there is bacterial infection, antibiotics can be given.
2. Symptomatic treatment: stay in bed at the acute stage. After the symptoms and signs improve and the electrocardiogram is normal, you can gradually increase the activity and give a nutritious and digestible diet. Cardiac insufficiency, arrhythmia and shock should be corrected actively.
3. Promote myocardial metabolism
(1) Vitamin C: 4 ~ 5g is added into 250ml solution for intravenous drip, once a day, 1 0 ~ 1 5 days is1course of treatment, which can be repeated.
(2) Energy mixture: ATP 20mg ++ coa 100 u+ cytochrome C30mg plus 5% glucose 500ml intravenous drip, once a day, 1 0 to 15 days is 1 course of treatment, which can be repeated.
(3) Inosine: 200 ~ 400 mg orally or intramuscularly, twice a day.
(4) Cyclic adenosine monophosphate (camp): 20 ~ 40 mg, intramuscular injection, twice a day.
(5) Polarizing solution: 500ml of 10% glucose and 8u of common insulin, and 15% potassium chloride 10ml intravenous drip, with 7 ~ 10 days as 1 course of treatment.
(6) Immunosuppressants: used for chronic and persistent cases. Glucocorticoid: Generally speaking, it is not recommended to use it within 10 ~ 14 days after onset, but it can be used for patients with high fever, heart failure, severe arrhythmia and cardiogenic shock. Prednisone 40 ~ 60 mg, daily 1 time, or hydrocortisone 400 ~ 600 mg, daily 1 time, intravenous drip, and gradually decrease after the condition improves for 26th.
Matters needing attention in patients with myocarditis
Patients with myocarditis should first have a full understanding of the disease, reduce the ideological burden, and realize that as long as they cooperate with the doctor's treatment, they will be able to overcome the disease and return to normal life and work as soon as possible. This requires patients to do the following after learning that they have myocarditis:
1. Patients with myocarditis should rest for at least 3 ~ 6 months, patients with dilated heart should rest for at least half a year, and physical activity should be restricted.
2. Strengthen nutrition. Patients with myocarditis should eat a diet rich in vitamins to ensure adequate protein, so as to facilitate the repair of myocardium and promote the recovery of the disease.
3. Preventing colds and colds will aggravate the condition of myocarditis and make relatively stable symptoms recur again, so patients with myocarditis should pay attention to avoiding colds and colds. Once you catch a cold, you should treat it in time to prevent it from further invading the myocardium.
4. Cooperate with the treatment of myocarditis patients should cooperate with the doctor's treatment with a positive attitude, and never take a pessimistic and depressed attitude. Because the prognosis of most myocarditis is good, as long as it is treated properly, it will not leave any sequelae. Patients should take medicine on time, but don't blindly abuse drugs. They should follow the doctor's advice and use drugs rationally.
5. Regular follow-up Patients with chronic myocarditis should go to the hospital for follow-up on a regular basis. You can review ECG and echocardiography to understand the development of the disease and facilitate future treatment.