继续医学教育
繼續醫學教育
계속의학교육
CONTINUING MEDICAL EDUCATION
2014年
11期
17-19
,共3页
室上速%治疗方法%综述
室上速%治療方法%綜述
실상속%치료방법%종술
Supraventricular tachycardia%Treatment%Summarize
阵发性室上性心动过速（PSVT）简称室上速。大多数心电图表现为QRS波群形态正常、RR间期规则的快速心律。大部分室上速由折返机制引起，患者通常无器质性心脏病表现，不同性别与年龄均可发生。心动过速发作突然起始与终止，持续时间各不相同。症状包括心悸、胸闷、焦虑不安、头晕，少见有晕厥、心绞痛、心力衰竭与休克者。症状轻重取决于发作时心室率快速的程度以及持续时间，也与疾病的严重程度有关系。如果心室率发作时过快，使心输出量与脑血流量突减或心动过速突然终止，窦房结未能及时恢复自律性导致心搏停顿，都可以导致晕厥。体检心尖区第一心音强度恒定，心律绝对规则。急性发作期治疗包括刺激迷走神经、药物治疗、食管心房调搏术、直流电复律。预防复发可用药物及导管消融技术。。
陣髮性室上性心動過速（PSVT）簡稱室上速。大多數心電圖錶現為QRS波群形態正常、RR間期規則的快速心律。大部分室上速由摺返機製引起，患者通常無器質性心髒病錶現，不同性彆與年齡均可髮生。心動過速髮作突然起始與終止，持續時間各不相同。癥狀包括心悸、胸悶、焦慮不安、頭暈，少見有暈厥、心絞痛、心力衰竭與休剋者。癥狀輕重取決于髮作時心室率快速的程度以及持續時間，也與疾病的嚴重程度有關繫。如果心室率髮作時過快，使心輸齣量與腦血流量突減或心動過速突然終止，竇房結未能及時恢複自律性導緻心搏停頓，都可以導緻暈厥。體檢心尖區第一心音彊度恆定，心律絕對規則。急性髮作期治療包括刺激迷走神經、藥物治療、食管心房調搏術、直流電複律。預防複髮可用藥物及導管消融技術。。
진발성실상성심동과속（PSVT）간칭실상속。대다수심전도표현위QRS파군형태정상、RR간기규칙적쾌속심률。대부분실상속유절반궤제인기，환자통상무기질성심장병표현，불동성별여년령균가발생。심동과속발작돌연기시여종지，지속시간각불상동。증상포괄심계、흉민、초필불안、두훈，소견유훈궐、심교통、심력쇠갈여휴극자。증상경중취결우발작시심실솔쾌속적정도이급지속시간，야여질병적엄중정도유관계。여과심실솔발작시과쾌，사심수출량여뇌혈류량돌감혹심동과속돌연종지，두방결미능급시회복자률성도치심박정돈，도가이도치훈궐。체검심첨구제일심음강도항정，심률절대규칙。급성발작기치료포괄자격미주신경、약물치료、식관심방조박술、직류전복률。예방복발가용약물급도관소융기술。。
Paroxysmal supraventricular tachycardia (PSVT) is hereinafter referred to as supraventricular tachycardia. Most of the electrocardiogram performance for normal QRS complex and the fast rhythm of the heart of RR interphase rules. Most supraventricular tachycardia is caused by exhumation mechanism, and patients usually have no organic heart disease, and the patients of different gender and age all can happen. Tachycardia attacks suddenly beginning and ending, and the duration of each are not identical. The symptoms usually include heart palpitations, chest distress, anxiety, dizziness, but rarely with syncope, angina pectoris, heart failure and shock. The symptom severity depends on the attack degree of rapid ventricular rate and duration, and also has relations with the severity of the disease. If the ventricular rate occurs too quickly, it can case the cardiac output and cerebral blood lfow reduction or tachycardia suddenly terminated, and sinoatrial node failed to restore self-discipline cause cardiac standstill, all of them can case syncope. So when the patient have a medical, the ifrst heart sound intensity will be constant, and the rhythm of the heart is well-regulated. The treatment of acute phase includes stimulate the vagus nerve, drug therapy, esophageal atrial cardiac surgery and dc cardioerter.besids, we can use drugs or catheter ablation techniques to prevent the relapse.
