常見異常心电图的监测与处理.pptVIP

常见异常心电图监测与处理长宁县人民医院 沈学杨;主 要 内 容;一、心脏电生理概述;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;窦房结:;心脏传导系统神经支配;心电图描记;24导额面心电图;24导横面心电图;正常心电图;心律失常;心律失常分类;心律失常分类;心律失常发生机制;心律失常发生机制;心律失常发生机制;窦性心律失常;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;窦性心动过缓;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;窦性停搏;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;窦房传导阻滞;病态窦??结综合症;病态窦房结综合症;病态窦房结综合症;第三节 房性心律失常;室性早搏;房性心动过速;2. 治疗 ①洋地黄中毒引起者：停用洋地黄，补钾，可选利多卡因、苯妥因钠及普奈洛尔等。 ②非洋地黄引起者：减慢心室率；可用IC类或Ⅲ类抗心律失常药物转复心律；药物治疗无效者，可考虑射频消融。 二、折返性房性心动过速 较为少见，治疗同阵发性室上速。 三、紊乱性房性心动过速 常发生于慢阻肺或心衰患者，也可见于洋地黄中毒。 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;心房扑动;心房扑动;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;心房颤动;心房颤动;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;四、治疗 1. 复律： ① 患者选择，需综合考虑：房颤持续时间；心房大小；病因。禁忌症：病因未除、心房大、房颤持续时间1年、SSS无起搏器保护。 ② 复律前的准备：经食管超声心动图确定有无心房附壁血栓；华法令：前三后四，INR控制在2.0～3.0；肝素：紧急复律时可以应用。 ③ 电复律：电转复推荐使用200 J或者更高；危险主要是栓塞和心律失常。 ④ 药物复律：奎尼丁、普罗帕酮（心律平）