危险性心律失常的急的救与护理(新).ppt

危险性心律失常的 急救与护理 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 主要内容 救治与护理 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 一、概 述 心律失常： 心脏冲动的频率、节律、起源部位、 传导速度或激动次序的异常。 危险性心律失常： 可迅速导致晕厥、心绞痛、心衰、休克 甚至心搏骤停的心律失常。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 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. 快速性心律失常： 阵发性室上性心动过速 心房颤（扑）动 室性心动过速 心室颤（扑）动 缓慢性心律失常： 窦性停博 (窦性静止) 房室传导阻滞 二度Ⅱ型AVB、三度AVB Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 二、病因与发病机制 器质性心脏病：急性冠脉综合征、心肌病、 先天性心脏病、病态窦房结综合征。 药物中毒：洋地黄、奎尼丁、胺碘酮等。 电解质紊乱：低血钾、高血钾、低血镁等。 QT延长综合征等。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 机理： 冲动的形成异常 窦房结、结间束、房室结的远端和希氏束-普肯野系统等处的心肌细胞均具有自律性。自主神经系统兴奋性改变或内在的病变，均可导致不适当的冲动发放。 此外,原来无自律性的心肌细胞,如心房、心室肌细胞,亦可在病理状态下出现异常自律性。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 机理： 冲动的传导的异常 冲动传导异常可以产生折返 折返是快速性心律失常的最常见的发病机制。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 三、病情评估与判断 初步评估 进一步评估 临床表现 心电图表现 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 初步评估 是否有脉搏是判断危险性心律失常的关键，血流动力学不稳定的心律失常往往需要立即处理。 脉搏 血流动力学是否稳定 昏厥、持续胸痛、低血压及其他休克征象 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 As