心电图2011-1-0215概要.ppt

* ○普罗帕酮 适用：AVRT、AVNRT、AAT及RAT，宽QRS波不易与VT鉴别时可首选 用法：1~2mg/kg/次，5~10min注完，一般首次70mg iv，必要时10~20min后重复，210mg。 注意：AT、AF或Af时，可致心室率↑↑，须先用西地兰、Ver或β-阻滞剂控制室率 * 室间隔左中1/3（右前下）较小的向量、心尖部（左前下）、左室除极（左后下）、基底部（左后上） * QRS waveform nomenclature The ECG consists of a small deflection called the P wave, arising from the atria, a more complicated deflection called the QRS complex due to ventricular depolarisation and a final T wave resulting from repolarisation of the ventricles. The QRS complex of waves is the largest deflection of the ECG and is always spiky in shape. All sharp deflections resulting from electrical activation of the ventricles are called QRS complexes. However, these waves can vary immensely in size, and arrangement. The QRS complex is very important when diagnosing myocardial infarction. In order to be able to describe these complexes, a nomenclature for the waves is needed. This can be done using combinations of the letters q, r, s, Q, R, S, lower case letters denoting small waves and upper case larger waves. The first positive wave is labelled with r or R Any second positive wave is labelled r′ or R′ A negative wave which follows an R wave or r wave is labelled S or s A negative wave that precedes an R or r wave, is labelled a q or Q wave Any wave that is entirely negative is labelled qs or QS. Using these rules and nomenclature all QRS complexes can be described, enabling more accurate diagnosis. * Asleep * 室间隔左中1/3（右前下）较小的向量、心尖部（左前下）、左室除极（左后下）、基底部（左后上） P-R间期：心房开始除极到心室开始除极的时间 P-R interval QRS时间：心室除极时间 QRS时间 ST段：心室复极缓慢期 Q-T间期：心室除极和复极的总时间 Q-T interval 心电图各波段的组成与命名 心电图波段 相应心电活动 P波 心房除极波 PR间期 房室传导时间 QRS波群 心室除极波 ST段与T波 心室复极的 缓慢期与快速期 R波：首先出现的位于参考水平线以上的正向波 Q波：R波之前的负向波 S波：R波之后的第一个负向波 R’波：S波之后的正向波 S’波： R’ 波之后的负向波 QS波：QRS波只有负向波 振幅小可称为q、r、s、r’、s’ QRS波群的命名原则 QRS波的命名 R r qR Qrs QS Qr Rs rS qs rSr’ rSR’ QRS波群的命名示意图 五、导联（Lead） 在人体不同部位放置电极，并通过导联线与心电图机电流计的正负极相连，这种记录心电图的电路连接方法。 实际上就是用不同连接方法，把心脏电活动导引到心电图机上。 不同导联（连接方法）反映不同部位心脏电活