心脏传导(谢燕萍)医.ppt

心脏传导阻滞;心脏传导阻滞;;心电信号传递和传导阻滞;传导阻滞;(二)、病因与分类;1.窦房阻滞;心内电图与体表心电图;心內电图与体表心电图;心內电图与体表心电图;心内电图与体表心电图;心内电图与体表心电图;心内电图与体表心电图;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.;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.;二度I型窦房传导阻滞：;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;二度II型窦房传导阻滞 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;2.房内阻滞;3.房室传导阻滞;(1)一度房室传导阻滞;;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;(2)二度房室传导阻滞;二度 I型(Morbiz I型)：;房室传导阻滞; 房室传导系统以 相对不应期延长为主 绝对不应期也有延长 既表现为传导延缓也有传导中断。;二度 Ⅱ型(Morbiz Ⅱ型) ;房室传导阻滞;二度II型房室传导阻滞发生机制 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;三度房室传导阻滞;房室传导阻滞 ;三度房室传导阻滞;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;;房室传导阻滞;房室传导阻滞;房室分离;房室分离;;束支、分支阻滞;右束支传导阻滞;右束支传导阻滞;右束支传导阻滞;右束支传导阻滞;左束支传导阻滞;左束支传导阻滞;左束支传导阻滞;左束支传导阻滞;左前分支传导异常;左前分支传导异常;左前分支传导异常;非特异性室内传导阻滞（IVCD）;谢谢;房室阻滞的心电图诊断热点; ; 现将临床关注的有关问题讨论如下;一、心电图诊断AVB的实用性和局限性;实用性;局限性;心电图分析中应注意：; 图1 A图为常规描记行LⅠ和LⅡ，示1：1房室传导； B图为走回病房（活动）记录，示2：1AVB; C图为用阿托品后记录，示几乎完全房室分离 ;夜间睡眠状态出现2度I型房室传导阻滞;（2）对阻滞区不能做出准确定位;（3）有些心律失常中AVB尚无诊断标准;二、一度房室阻滞与PR间期延长; PR间期延长是一度AVB基本ECG表现 PR间期正常不能排除一度AVB PR间期延长也不都是一度AVB PR间期能延长到何等程度？ T波（或R波）前的P波能否下传心室？ PR间期延长是否需要治疗？;1．PR间期正常的一度房室阻滞;2．PR间期