二、心脏起搏治疗及的护理-储海燕.ppt

生活指导 避免强磁场和高电压的场所（如核磁、激光、变电站等），但家庭生活用电一般不影响起搏器工作。 健康指导 生活指导 移动电话对起搏器的干扰作用很小，推荐平时将移动电话放置在远离起搏器至少15cm的口袋内，拨打或接听电话时采用对侧。 健康指导 定期随访 　 出院后半年内每1～3个月随访1次，情况稳定后每半年随访1次，接近起搏器使用年限时，应缩短随访间隔时间，在电池耗尽之前及时更换起搏器。 健康指导 谢 谢 聆 听 * Student Notes学员注释 The conduction system in a normal heart is comprised of and operates in the following way: 正常心脏的传导系统的组成和运作模式： The sinus node, located in the upper right atrium (known as the heart’s ‘Natural Pacemaker’), has ‘automaticity’, which will be discussed later. The sinus node’s rate of automaticity is normally faster than all other parts of the heart, and therefore, dictates the rate at which the entire heart beats. This is known as “Sinus Rate.” Its resting rate is usually between 60-80 bpm in an adult, but it responds to metabolic demands, changing its rate as the need for oxygenated blood changes, for example,` in response to exercise, stress, hormones, etc. 窦房结，位于右心房上部（被称之为心脏的“天然起搏器”），具有自律性。关于这一点，我们以后会讨论到。窦房结的自律心率通常比心脏其它所有部位的自律性都要快，因此，控制决定了整个心脏跳动的心率快慢。被称之为“窦性心率”，成年人休息时心率大约在每分钟60~80次，可以根据代谢需求而改变。如果氧和血液需求发生变化，心率就发生改变，例如，运动、应激、激素分泌等等情况。 Instructor Notes教员注释 Auto-animated slide自动演示幻灯 * Student Notes学员注释 The atrioventricular node (aka: AV node, AV junction) is located between the atrium and the ventricles, in the inter-atrial septum, close to the tricuspid valve. It receives the impulse from the SA node and delivers it through the Bundle of His (the forefront of the His-Purkinje network). 房室结（简称AV node或房室交界处AV Junction)位于心房和心室之间的房间隔，接近三尖瓣。主要接受来自窦房结的脉冲，将其通过希氏束下传（浦金野纤维的前部）。 Conduction through the AV node is slow, allowing appropriate time for the atria to complete mechanical contraction prior to ventricular contraction. 房室结的传导比较缓慢，允许在心室收缩前心房有适宜时间完成机械收缩。 If the SA node fails to deliver an impulse to the AV node, the AV node itself will deliver an impulse to the Bundle of His at rates between 40-60 bpm. 如果窦房结未能发放脉冲到房室结，房室结自身会发放频率在40-60次/分的脉冲到希氏束。 Instructor Notes教员注释 Auto-animated slide 自动演示幻灯 * Student Notes学员注释 Bundle of His with the A