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利多卡因为一治疗室性心律失常(由于急性心肌梗死、洋地黄中毒、心脏手术、插心导管所致)的有效药物。由于它作用迅速,对循环的抑制作用较少,因此广泛地被应用于临床。过去还未见利多卡因造成致死性窦性停搏的报导。作者曾对一88岁的因心肌梗死、肺水肿,出现多灶性室性早跳的冠心病患者以利多卡因200毫克分次静脉注射,但很快出现窦性停搏,经抢救无效而死亡。一些研究指出,利多卡因的药理作用是通过降低心肌的兴奋性、延长反拗期和延长房室传导时间,来提高心肌舒张期电刺激的阈值的。心室搏动中心的发动频率的减少,可能是由于肌纤维舒张期除极过程的延长。而产生窦性停搏的原理,可能是①窦房结的除
Lidocaine is an effective drug for the treatment of ventricular arrhythmias (due to acute myocardial infarction, digitalis poisoning, cardiac surgery, catheterization). Because of its rapid role in the inhibition of the circulation less, it has been widely used in clinical. There have been no reports of lethal sinus arrest caused by lidocaine in the past. The authors of a 88-year-old due to myocardial infarction, pulmonary edema, multifocal ventricular premature beats in patients with coronary heart disease lidocaine 200 mg intravenous injection, but soon appeared sinus arrest, the rescue and ineffective death. Some studies point out that the pharmacological effect of lidocaine is to increase the threshold of myocardial diastolic electrical stimulation by decreasing the excitability of the myocardium, prolonging the anti-bradykinesia, and prolonging AV conduction. The decrease in the frequency of onset of ventricular beats may be due to prolonged diastolic depolarization of muscle fibers. The principle of sinus arrest, may be ① addition to the sinus node