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活动在房性或交界性逸搏及加速性逸搏心律
中的临床应用
【摘要】 目的通过提高交感神经兴奋性使窦房结产生的激动增加，当窦房结产生的激动超过心房或交界区的异位激动,即夺获心房和心室，以此来初步判断窦房结功能，探讨房性或交界性逸搏及加速性逸搏心律的诊断、鉴别诊断，分析其产生机制和原因。方法对随机遇到的房性或交界性逸搏及加速性逸搏心律进行活动后描记心电图，并静卧观察其心电图变化。结果活动后的心电图均转为窦性心律，静卧观察心电图变化，结果是随着窦性心律减慢，当接近活动前心率时偶见竞争心律或房性融合波外，多直接转为活动前异位心律。结论活动前后平均心率分别为(71±16.3)次/min和(80±17.6)次/min(P<0.05)，活动起到提高窦性节律的效果，对房性或交界性逸搏及加速性逸搏心律起到明确诊断及鉴别诊断的作用，能初步判断窦房结功能良好。产生机制：加速性逸搏心律可能是由于神经体液失衡，异位起搏点兴奋性增加所致;而逸搏心律是由于迷走神经张力过强，窦性节律减慢的结果。其产生的原因多为功能性改变，少数可能为器质性变化。
【关键词】 活动;房性;交界性;逸搏心律;加速性逸搏心律 Clinical study on the activity which is in the atrial junctional and accelerating escape rhythm
WANG You-wu.The Affiliate Hospital of Jining Medical Colldege,Jining 272029,China
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[Abstract]ObjectiveImproving sympathetic newes
excitement makes the sinucatrial node`s concussion in crement .When the concussion of sinucatrial node exceed atrium and atrioventricular nodal region`s different concussion. It will take over atrium and ventricles.This can basically judge sinuatrial node function, also it can inqure into atrial to connect or accelerate escape rhythm diagnosis and differential diagnosis. This method can help to analyse its mechanism and reason.MethodsThe ECG of atrial junctional and accelerating escape rhythm is recorded after activty. We observed the ECG which aperson is claming down and lying.ResultsThe ECG after activity all turn into sinus rhythm. We observed the ECG which a person is calming clown and lying. The result is that when sinus rhythm reduces close to heart rate before movement. We will disconer the competition rhyhm and atrium fusion wave auidentally most of that directly turn into different heart tate before activity .ConclusionThe heart rate of activity in front and back are(71±16.3)times/min and(80±17.6)times/min (P<0.05),activity can rise sinus rhythm and explict diagnosis atrial.Junctional and accelerating escape rhythm also can basically judge that the sinuatreal wode functien is good. Producing mechanism: accelerating escape rhythm may be because
2页
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the nerve and body fluid are out of balance and different pacemaker point excitement is increasing. But escape rhythm is because of pheumogastric nerves tension over strong and sinus rhythm reducing. The reasons for the change of function, may be as organic changes
[Key words]activity;atrial; junctional; escape rhythm; accelerating escape rhythm
加速性(房性、交界性或室性)逸搏心律，亦称加速性(房性、交界性或室性)心动过速、非阵发性(房性、交界性或室性)心动过速等，与(房性、交界性或室性)逸搏心律是一种较为常见的心律失常，本文通过对房性或交界性逸搏及加速性逸搏心律进行活动后描记常规心电图，并观察其结果，现报道如下。
1资料与方法
1.1一般资料随机遇到的来本院就诊的门诊或住院病例共计121例，年龄14～74(40±17.5)岁,男52例,女69例。其中高血压、冠心病37例，占30.6%;其他(包括健康查体、一般常规检查，各种疾病及外伤术前检查等)84例，占69.4%。
1.2方法对常规心电图检查诊断或拟诊断为房性或交界性逸搏及加速性逸搏心律，在心电图机与四肢导联连接的情况下，嘱其在检查床上做起躺动作一般在10次左右，活动不限极量，主要为提高窦房结兴奋性，使窦性激动超过异位激动夺获心房、心室。基础心率较慢者运动次数可以少些，基础心率较快运动次数可以多些，并通过心
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