Short P-R syndrome James bunch type surges the healing solution _'s treatment of syndrome in advance

Short P-R syndrome James bunch type surges the healing solution _'s treatment of syndrome in advance
Healing solution
There is no treatment surging syndrome in advance of complication: Find that surges syndrome in advance as to the physical examination electrocardiogram, but there are no persons who happen of complication, do not need to treat, but need to follow the trail of and observe. Defy syndrome to amalgamate the treatment of fast arrhythmia in advance:
1.Break out the intersection of drug therapy and caused by existence that the ventricle surges in advance fast the intersection of and arrhythmia of issue, it frequently causes dynamics changing and person who has symptom of the blood flow to especially break out, drug therapy in conformity with doing immediately.
(1)Spreading type) before suitable a turning towards type ' The treatment when returning tachycardia of room room breaks out: See " treatment of sex tachycardia on the popping room " .
(2)Defy syndrome to amalgamate the atrium to quiver (atrium is fluttered) in advance Hour's treatment: Defy syndrome amalgamate atrium, quiver and amalgamate against the intersection of room and the intersection of room and returning tachycardia of spreading etc. in advance some scholar, always called defying syndrome to amalgamate QRS wave and increase the wide fast arrhythmia in advance. Nearly have defying syndrome to amalgamate fast arrhythmia in advance of 30%, QRS wave deformity is increased widely in the electrocardiogram. Urgency that emergency call punish break out, speed and the intersection of blood flow and dynamics of ventricle rate receive effect depend on tachycardia.
The dynamics situation of the blood flow is not good (with serious hypotension,etc.) Or fair, rhythm of the heart not normal tachycardia soon the intersection of duration and elder relatively, should first choose, reply law (have, reply the intersection of law and apparatus or have the intersection of taboo and card to reply by cable law) by cable .
The dynamics situation of the blood flow is fair, tachycardia still ability of the arrhythmia is received, should try out drug therapy first. Should select for use, can lengthen the intersection of room and the intersection of room and bypass, answer issue and inhibit medicine to conduct function its from.
A.Ketone of general Luo's handkerchief: It is often first-selected medicine. Dosage 70mg or 1.0- 1.5mg/kg, the vein is injected slowly after dilute with 5% of the glucose liquid 20ml, it should be greater than 5min to inject time, usually in 5- 7min. If invalid, should be spent once while being repeatable behind 15- 20min. It is effective that most patients use 70- 140mg. Ketone of general Luo's handkerchief (rhythm of the heart is flat) It can lengthen room room forming, bypass to and not answering reversely effectively by issue,it delay or block bypass to and not conducting reversely, inhibit the malposition from beating, therefore can stop tachycardia or slow down ventricle rate. It is flat that the vein injects ketone of general Luo's handkerchief (rhythm of the heart) And then, each take half, average dosage 107.9mg (70- 190mg) replying about law and person who slows down rate of ventricle . Ketone of general Luo's handkerchief (rhythm of the heart is flat) Should pay attention to the following two points while using: a.A few the intersection of patient and the intersection of administration and central the intersection of room and rate might be increased fast, therefore the arrhythmia is aggravated. This may delay, conduct in the room with medicine this, slow down the intersection of atrium and rate, lead to the fact the intersection of room and the intersection of room and marry or bypass 1: 1 is conducted and had something to do. For example 2 before using medicine: 1 is conducted, because atrium rate is slowed down to cause 1 while using medicine: 1 is conducted, the rate multiplication of ventricle; b. Ketone of general Luo's handkerchief (rhythm of the heart is flat) There is inhibitory activity, especially the dosage is big or the bad one of heart function on myocardium contractile force, can the hypotensive state take place after replying law. If can know indication strictly, this medicine is safe and effective.
B.Procaine amine: Someone maintains as the first-selected medicine, the dosage 0.5g is dissolved into 40ml liquid (5% of the glucose) ,The vein injects 10min, namely 50mg/min (suitable for adults) slowly ,To the total amount 10- 14mg/kg, it is 88% to be efficient. Procaine amine can be obviously lengthened to too effective to answer one in front of the bypass, but medium extension too reverse effective to answer one and one among prominent extension P-A.
C.Amine iodine ketone: Amine iodine ketone stops defying syndrome to amalgamate atrium quivering or atrium to flutter acutely and break out in advance, it can be up to 80% that efficient. The dosage is 3mg/kg each time, the vein is injected slowly after dilute with 5% of the glucose liquid or physiological saline 20ml, the speed is proper for 15- 20mg/min. If invalid after 10- 15min can be repeated once, can't exceed the total amount 9mg/kg. Song have city report 12 acute break out, iodine ketone average dosage 455.8mg (150- 900mg) ,Stop 5 of breaking out etc., reply law but the intersection of ventricle and the intersection of rate and 3 of slowing down etc., the intersection of ventricle and rate it increases to be nearly 4; Over half the intersection of example and times of patient on intravenous to inject amine take place in the the intersection of iodine and ketone blood pressure drop, forced to stop using medicine and implementing and replying law by cable. Report Shang Shao at home, must accumulate the materials, the amine iodine ketone ventricle rate of the quiet note is increased fast, the hypotensive effect that may be caused with the medicine, cause the excitement of sympathetic nerve, catecholamine release, impel the bypass to conduct and have something to do with higher speed. The ventricle rate increases and aggravates the cardiac muscle with hypotension ischemically fast, bring out the room tachycardia or potential danger that the ventricle quivers, should watch out for.
D.Other medicines: a.Fluorine card Nicaragua: Can consider application, the dosage is 1- 2mg/kg, the vein is injected slowly after dilute with 5% of the glucose liquid 20ml, or instil with 0.2mg/kg lasting vein, maximum dose is less than 150mg. b.The Kui 's: Vibrant to turn, reply the result fine to atrium, oral administration rotates and replies slower. c.Lidocaine: Also have certain curative effect amalgamating atrium quivering or person who flutters atrium to WPW syndrome. One group reports 3 times, after the result uses lidocaine, reply each of law 2, ventricle rate slows down each. Have, report, spread, should not it answers issue to be getting short lidocaine of application in front of the bypass, it can make ventricle rate increase, bad function of quivering etc. the ventricle takes place. So, it is proper to use this medicine on condition that guard and get the electricity defibrillating device ready. d. receptor blocks medicines: Have to bypass function is unsuitable to use separately, should not lengthen room room form, answer issue and delay and medicine conducted to block share. In addition, accelerate atriums and quiver in the report of ventricle rate while breaking out too.
E.Foreign the intersection of digitalis and the intersection of preparation and mao spend the intersection of glucoside and C (west blue) , Vera rice (different to fight definitely) handkerchief have Should forbid. Foreign the intersection of digitalis and the intersection of preparation and mao spend the intersection of glucoside and C (west blue) Can make in front of the bypass of patient spreading, answering one shorten, and the normal room room conducts the system and is blocked, more atriums will be excited through spreading the ventricle under the bypass, will make ventricle rate increase fast suddenly, and can cause the vibrant emergence of ventricle. So should forbid. Vera rice (different to fight definitely) handkerchief have Answer bypass directness of issue act on relatively light, can increase and worsen with dynamics of blood flow fast through following two the intersection of respect and rate of ventricle enabled: a.Inhibit the room room from forming and conducting and making the atrium excited and spreading from the bypass; b.Apply through hypotension and the excited sympathetic nervous system of reflectivity, shorten the too effective to answer one of bypass, so should forbid. Have atrium quiver intermission of history defy the intersection of syndrome and patient should forbid the intersection of Vera and rice (different to fight definitely) handkerchief too in advance . If fail to respond to any medical treatment by the above-mentioned medicine or because the arrhythmia is aggravated or the critical one of condition development, person who aggravates obstacle of blood flow dynamics, should implement and reply law by cable synchronously at once. Most patients through replying success of law, and does not have more complications, it is comparatively safe, reliable to point out and reply law by cable.
2.Break out the intersection of intermittence and treatment of issue to defy syndrome amalgamate tachycardia break out number of times to be little duration short in advance, symptom obvious can transfer the intersection of intermittence and issues of patient that reply to by oneself, can needn't treating. But should avoid overworking and other risk factors. Have room nature shrink before the issue, room shrink, happen, should take general Luo handkerchief the intersection of ketone and (flat rhythm of the heart) before the issue , American west law (the slow rhythm of the heart) When correcting, can reduce the number of times of outbreak of tachycardia. As to defy syndrome amalgamate tachycardia, break out the intersection of number of times and frequent the intersection of intermittence and issues of patient in advance, should take the above-mentioned keeping amount of treating the effective medicine and prevent from recuring for a long time, can also check the method to bring out arrhythmia through the electric physiology of heart. In the intermittence one, the frequent patient, should adopt the way of effecting a radical cure to breaking out. The skill of mostly adopting the radio frequency and melting at present, success rate can be more than 95%.
3.The synchronous direct current heart replies law by cable Reply law (power 100 by cable- 200J) To stop the intersection of room and the intersection of room and tachycardia of returning etc. and defy syndrome amalgamate atrium, quiver effective in advance, defy in advance as the lattering makes QRS wave in the electrocardiogram increase the wide and deformity, room tachycardia is difficult to distinguish, so that while selecting medicines for use and becoming difficult, and is led to the fact dynamics of blood flow is particularly applicable when there are obvious obstacles by the arrhythmia fast. Reply law, still need to keep with medicine.
4.The skill of surging the surgical treatment of syndrome and melting in the radio frequency of the conduit in advance is before launching, to defying syndrome to carry on the surgical treatment in advance, cut off or with injecting or some frozen bypass of absolute alcohol, having made better curative effect, the cure rate is 80%. But because the wound is great for the surgical law, it is difficult to employ extensively, has already been melted the skill by the radio frequency of the conduit and replaced. Only in cases some is special, for example the congenital heart disease of syndrome or person who needs operation of heart disease of the sex of the day after tomorrow with surging in advance. Can consider, do at the same time surgical the intersection of law and treatment surge syndrome in advance.
5.Since defying the radio frequency of conduit of syndrome to melt and treat in 1987 in advance, melt (RFCA) by the radio frequency of the conduit Treatment defy syndrome amalgamate fast the intersection of and arrhythmia, make great success already in advance. The radio frequency of the conduit melts the skill treatment surges the appraisal of syndrome in advance:
(1)The adaptation card defying syndrome to melt by the radio frequency of the conduit in advance:
Kind: A.There is returning tachycardia of room of continuation room of symptom, the medicine fails to respond to any medical treatment or the patient can't tolerate, or unwilling to take and resist the person who controls above-mentioned arrhythmia of arrhythmia medicine for a long time. B.Atrium quiver other fast room the intersection of person who spread and fast the intersection of ventricle and the intersection of rate and patient in front of the bypass, companion of arrhythmia, the medicine fails to respond to any medical treatment or the patient can't tolerate, or unwilling to take and resist the arrhythmia medicine for a long time.
2Kind: A.Check or melt returning tachycardia of room room verified in the other arrhythmia course of treatment in electric physiology, or atrium quiver the intersection of companion and the intersection of person who spread and fast the intersection of ventricle and the intersection of rate and patient in front of the bypass. B.There is not surging a syndrome patient in advance of symptom, because spontaneity fast arrhythmia and unusual electrocardiogram may influence the patient's life, employment, important activity and state of mind and public and safe. C.The atrium quivers with the biography in front of the bypass, but ventricle rate does not unhappy. D.The patient has source history of dying suddenly of family heart.
Kind: Drug therapy is effective and therapeutic room room returning tachycardia patient it of ability, wish to take medicines but not melt and control the arrhythmia for a long time even more.
(2)The high security that the radio frequency melts: Melted by the conduit with the electric current of low-yield radio frequency. Because it does not have direct current that hit the obvious heat damage of cardiac muscle brought, do not need general anesthesia, does not produce the atmospheric pressure wounded, seldom cause the cardiac muscle to pierce through, bring out arrhythmia seldom also, can release the electric current of radio frequency and melt in large positions, many times, the patient does not have any feeling and agony.
(3)The success rate that the radio frequency melts: Can be more than 90%. But success rate relates to the skill person's experience obviously. It is 93.1% that much pieces of bypass melt and treat success rate, it is 96% that the bypass of vertically-hung scroll of painting or calligraphy melts and treats success rate. It is 99.1% that the left bypass treats success rate, it is 97.5% that bypass on the right side treats success rate.
(4)The radio frequency melts the bypass treatment surges recurring rate and miss ratio of syndrome in advance: It is 1%- 9% that the radio frequency melts and surges the recuring rate of syndrome in advance in 1 year after the operation, the single bypass recuring rate (in one year) 1.9%, more than the intersection of bypass and recuring rate (in one year) It is 7.6%. The left bypass recuring rate (1 Within the year) It is 1.5%, bypass on the right side is 4.1%. Such as recur, can do again radio frequency melt skill treatment, success rate is still very high. Radio frequency melt, treat, it fails to be invisible to defy and account for 34% in advance in the case. 6.The planting into heart can consider employing the planting to reply the law defibrillating device into heart to reply the law defibrillating device when medicine failing to respond to any medical treatment or radio frequency of conduit melt to fail.
Complication Because short P-R syndrome is apt to amalgamate sex tachycardia on the popping room, and the frequency appears very fast, can cause the intersection of blood flow and dynamics change, appear hypotension, room fast arrhythmia (atrium flutter and atrium quiver) , complications such as ventricle quivering or sudden death,etc..
|