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1、LOGO心脏电复律心脏电复律主讲人：王念主讲人：王念 适适 应应 症症 2 操操 作作 过过 程程4 禁禁 忌忌 症症3 35 注注 意意 事事 项项 心脏电复律心脏电复律 定定 义义3 1Company Logov定义：定义：定义：定义：是在短时间内向心脏通以高压强电流，使心肌瞬间同时除极，消除异位性快速心律失常，使之转复为窦性心律的方法v最早用于消除心室颤动，故亦称为心脏电除颤 心脏电复律心脏电复律Company Logo 心脏电复律心脏电复律适适应应症症绝对适应症绝对适应症：心室颤动心室颤动、心房扑动心房扑动（非同步）相对适应症相对适应症：1.1.心房颤动心房颤动和扑动扑动（同步）2.2
2、.阵发性室上速阵发性室上速、室速室速、预激综预激综合征伴快速心律失常者合征伴快速心律失常者（同步）Company Logo 心脏电复律心脏电复律禁禁忌忌症症心脏明显增大及心房内有新鲜血栓；近心脏明显增大及心房内有新鲜血栓；近心脏明显增大及心房内有新鲜血栓；近心脏明显增大及心房内有新鲜血栓；近3 3 3 3个月有个月有个月有个月有栓塞史栓塞史栓塞史栓塞史伴高度或完全房室传导阻滞的心房颤动或扑动伴高度或完全房室传导阻滞的心房颤动或扑动伴高度或完全房室传导阻滞的心房颤动或扑动伴高度或完全房室传导阻滞的心房颤动或扑动伴病态窦房结综合征的异位性快速心律失常伴病态窦房结综合征的异位性快速心律失常伴病态窦房
3、结综合征的异位性快速心律失常伴病态窦房结综合征的异位性快速心律失常有洋地黄中毒、低血钾时，暂不宜电复律有洋地黄中毒、低血钾时，暂不宜电复律有洋地黄中毒、低血钾时，暂不宜电复律有洋地黄中毒、低血钾时，暂不宜电复律Company Logo 心脏电复律的分类心脏电复律的分类非同步直流电复律非同步直流电复律同步直流电复律同步直流电复律适应症适应症心室颤动心室颤动心室扑动心室扑动除心室颤动以外的快除心室颤动以外的快速型心律失常速型心律失常特点特点1.病情紧急，意病情紧急，意识丧失，立即除颤识丧失，立即除颤2.无心动周期，无无心动周期，无QRS波波3.争分夺秒争分夺秒1.一般为择期，可做一般为择期，可做好
4、准备好准备2.电流与电流与R波同步波同步房颤、室上速：房颤、室上速：100150J房扑：房扑：50100J室速：室速：100200J选择能量选择能量200360JCompany LogoCompany Logo物物 品品 准准 备备v除颤仪、导电糊、生除颤仪、导电糊、生理盐水、无菌纱布、理盐水、无菌纱布、氧气氧气v地西泮地西泮v抢救设备及药品抢救设备及药品Company Logo 复复 律律 中中 配配 合合v平卧于绝缘的硬板床，松开平卧于绝缘的硬板床，松开衣领，取下义齿，建立静脉衣领，取下义齿，建立静脉通道，给予氧气吸入通道，给予氧气吸入v清洁电击处皮肤，链接心电清洁电击处皮肤，链接心电导联
5、导联v遵医嘱静脉推注地西泮遵医嘱静脉推注地西泮0.30.5mg/kg，严密观察，严密观察呼吸呼吸Company Logo 复复 律律 中中 配配 合合v连接电源，打开开关，连接电源，打开开关，选择选择“同步同步”或或“非非同步同步”按钮按钮v能量选择能量选择v电极板均匀抹导电糊电极板均匀抹导电糊v电极板位置电极板位置Company Logo电极板位置电极板位置心尖部心尖部心尖部心尖部:左腋前线内第左腋前线内第左腋前线内第左腋前线内第5 5肋间肋间肋间肋间 心底部心底部心底部心底部:胸骨右缘第胸骨右缘第胸骨右缘第胸骨右缘第2323肋间肋间肋间肋间Company Logo复复 律律 中中 配配 合
6、合v充电充电v放电放电v记录记录Company Logo复律后注意事项复律后注意事项Company LogoDiagramThemeGallery is a Design Digital Content&Contents mall developed by Guild Design Inc.TitleAdd your textThemeGallery is a Design Digital Content&Contents mall developed by Guild Design Inc.Company Logo Cycle DiagramTextTextTextTextTextCycle
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