心动过速性心肌病患者的临床抢救与护理

Clinical rescue and care of the cases with tachycariomyopathy (TCMP)

目的 通过救治观察心动过速性心肌病 (TachycariomyopathyTCMP)患者 ,分析其发生发展与诊治转归 ,探讨并实施对TCMP患者的护理。方法 对慢性快速性室性心动过速者采用抗心律失常药物、射频消融、电复律治疗并实时监护护理 ,对比其心率、心电图、心脏大小、心功能变化。结果 治疗前、后与随访 1个月患者心率分别为170bpm、75bpm、6 0bpm ;终止室速转窦性心律时与出院及随访 1个月心电图P波、Ptfv1的变化分别为 :P波振幅 0 .3mv、0 .1mv、0 .0 5mv ,时限 12 0ms、10 0ms、80ms;Ptfv1为 - 0 .0 6mm .s、- 0 .0 1mm .s、Pw0 .0 5mm .s;心胸比分别为 0 .5 4、0 .44、0 .42 ;左室舒张末期内径分别为 6 3mm、5 0 .2mm、47mm ;左心房前后径分别为 32mm、2 3mm、2 5 .3mm ;心功能分别为Ⅳ级、Ⅱ级、I级 ;以上证实心动过速性心肌病于控制心室率后 ,心脏逐渐缩小 ,心功能逐渐恢复。结论 :慢性心动过速是导致心脏扩大和心功能降低的唯一因素 。

Objective: TO analyse the developing prognosis of TCMP and discuss the nursing of TCMP patients in the rescue and exam the patients with TCMP. Methods: Antiarrhymatic drugs, RFCA, electric cardioversion were used to treat patients with TCMP and the HR ECG size and function of heart during the examination were compared. Results: The patient's HR range were 170 bpm?75 bpm?60 bpm; ECG after the recovery of sinus rhythm and after 1 month's following up P ware amplitude were 0.3 mv?0.1 mv?0.05 mv; persistence time was 120ms?100 ms?80 ms; Ptfv1 was -0.06 mm.s?-0.01 mm.s?Pw0.05 mv; heart/chest ratio was 0.54?0.44?0.43; left ventricular relaxation size were 63 mm?50.2 mm?47 mm; left atrial size was 32 mm?23 mm?25.3 mm; pumpfunction of heart was Ⅳ?Ⅱ?Ⅰ; all the results indicated that the heart size reduced and that function recovered after HR was controlled on patients of TCMP. Conclusion: Chronic tachycardia is the only cause to lead to the enlargement of heart and the decrease of pump function and the control over HR can help recover the pump function to normal.