{"id":55237,"date":"2025-08-03T05:10:15","date_gmt":"2025-08-03T05:10:15","guid":{"rendered":"http:\/\/zydq.1006ss.com\/?p=55237"},"modified":"2025-08-03T05:10:15","modified_gmt":"2025-08-03T05:10:15","slug":"%e6%88%bf%e5%ae%a4%e7%bb%93%e6%8a%98%e8%bf%94%e6%80%a7%e5%bf%83%e5%8a%a8%e8%bf%87%e9%80%9f%e7%9a%84%e7%94%b5%e7%94%9f%e7%90%86%e6%a3%80%e6%9f%a5%e5%8f%8a%e5%b0%84%e9%a2%91%e6%b6%88%e8%9e%8d","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=55237","title":{"rendered":"\u623f\u5ba4\u7ed3\u6298\u8fd4\u6027\u5fc3\u52a8\u8fc7\u901f\u7684\u7535\u751f\u7406\u68c0\u67e5\u53ca\u5c04\u9891\u6d88\u878d"},"content":{"rendered":"

\u623f\u5ba4\u7ed3\u6298\u8fd4\u6027\u5fc3\u52a8\u8fc7\u901f (AVNRT)  \u662f\u4e34\u5e8a\u4e2d\u6700\u4e3a\u5e38\u89c1\u7684\u5ba4\u4e0a\u6027\u5fc3\u52a8\u8fc7\u901f\uff0c\u4e5f\u662f \u5c04\u9891\u6d88\u878d\u6cbb\u7597\u7684\u4e3b\u8981\u5fc3\u5f8b\u5931\u5e38\u7c7b\u578b\u4e4b\u4e00\u3002\u901a\u5e38\u591a\u89c1\u4e8e\u5973\u6027\uff0c\u4e14\u968f\u7740\u5e74\u9f84\u589e\u957f\u5176\u53d1\u751f\u7387 \u6108\u9ad8\u3002\u65e9\u671f\u4eba\u4eec\u5bf9AVNRT \u7684\u8ba4\u8bc6\u6709\u9650\uff0c\u6cbb\u7597\u7684\u65b9\u6cd5\u5305\u62ec\u5916\u79d1\u624b\u672f\u53ca\u76f4\u6d41\u7535\u6d88\u878d\u6548\u679c \u5747\u4e0d\u5c3d\u5982\u4eba\u610f\uff0c\u4e14\u98ce\u9669\u8f83\u9ad8\u3002\u5c04\u9891\u6d88\u878d\u6cbb\u7597\u662f20\u4e16\u7eaa80\u5e74\u4ee3\u672b\u51fa\u73b0\u7684\u4e00\u9879\u6280\u672f\uff0c\u968f \u7740\u6280\u672f\u7684\u53d1\u5c55\u53ca\u4eba\u4eec\u8ba4\u8bc6\u7684\u63d0\u9ad8\uff0c\u5c04\u9891\u6d88\u878d\u6cbb\u7597\u7684\u6210\u529f\u7387\u51e0\u8fd195%\u4ee5\u4e0a\uff0c\u800c\u4e14\u5b89\u5168 \u6027\u9ad8\uff0c\u4ece\u6839\u672c\u4e0a\u53d6\u4ee3\u4e86\u5176\u4ed6\u65b9\u6cd5\uff0c\u662f\u76ee\u524dANVRT \u6cbb\u7597\u7684\u9996\u9009\u65b9\u6cd5\u3002<\/p>\n

\u623f\u5ba4\u7ed3\u7684\u89e3\u5256<\/p>\n

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\u623f\u5ba4\u7ed3\u533a\u5305\u62ec\u4f4d\u4e8e\u4e0a\u65b9\u7684\u90e8\u5206\u53f3\u5fc3\u623f\u53ca\u5de6\u5fc3\u623f\u3001\u623f\u95f4\u9694\u3001\u4e2d\u592e\u7ea4\u7ef4\u4f53\u3001\u4e8c\u5c16\u74e3\u548c \u4e0b\u65b9\u7684\u53f3\u5fc3\u623f\u3001\u4e09\u5c16\u74e3\u9694\u74e3\u3001\u5ba4\u95f4\u9694\u7684\u53f3\u5ba4\u9762\u3002<\/p>\n

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1.\u6765\u81ea\u53f3\u623f\u4e0b\u90e8\u3001\u4e09\u5c16\u74e3\u73af\u3001\u623f\u95f4\u9694\u4e2d\u90e8\u548c\u5de6\u623f\u7684\u5fc3\u808c\u7ea4\u7ef4\uff0c\u63d2\u5165\u6c47\u5408\u81f3\u623f\u5ba4\u7ed3\u7684\u8868\u5c42\u3002\u5176\u5185\u4e3a\u6563\u5728\u7684\u7ed3\u533a\u7ec6\u80de\uff0c\u4f53\u79ef\u8f83\u5c0f\uff0c\u4e2d\u95f4\u6df7\u5408\u6709\u4e0d\u540c\u7a0b\u5ea6\u7684\u5fc3\u623f\u7ec6\u80de\u3001\u8102 \u80aa\u3001\u80f6\u539f\u7ea4\u7ef4\u53ca\u795e\u7ecf\u7ea4\u7ef4\u3002<\/p>\n

2. \u4e2d\u5c42\u7ec6\u80de\u8f83\u4e3a\u81f4\u5bc6\uff0c\u7ec6\u80de\u6392\u5217\u548c\u8d70\u5411\u4e0d\u4e00\uff0c\u80f6\u539f\u7ea4\u7ef4\u76f8\u5bf9\u8f83\u5c11\uff0c\u4ec5\u6709\u5c11\u91cf\u7684\u795e\u7ecf\u7ea4\u7ef4\u548c\u8102\u80aa\u7ec4\u7ec7\u3002<\/p>\n

3.\u6df1\u5c42\u7ec6\u80de\u66f4\u4e3a\u81f4\u5bc6\uff0c\u7ec6\u80de\u6392\u5217\u53ca\u8d70\u5411\u53d8\u5f02\u8f83\u5927\uff0c\u80f6\u539f\u7ea4\u7ef4\u660e\u663e\u5c0f\u4e8e\u8868\u5c42\u548c\u4e2d\u5c42\u3002<\/p>\n

Tawara\u6700\u65e9\u5bf9\u623f\u5ba4\u7ed3\u8fdb\u884c\u4e86\u7814\u7a76\uff0c\u63d0\u51fa\u623f\u5ba4\u7ed3\u4f4d\u4e8e\u623f\u95f4\u9694\u8fd1\u4e09\u5c16\u74e3\u73af\u5904\uff0c\u4f4d\u4e8e Koch\u4e09\u89d2\u5185\u3002Koch\u4e09\u89d2\u662f\u7531Todaro\u8171(\u524d\u4e0a\u65b9)\u3001\u51a0\u72b6\u9759\u8109\u7aa6\u53e3(\u540e\u65b9)\u548c\u4e09\u5c16\u74e3<\/p>\n

\u9694\u74e3\u7ec4\u6210\u3002\u89e3\u5256\u5b66\u623f\u5ba4\u7ed3\u4f4d\u4e8e\u95f4\u9694\u819c\u90e8\uff0c\u5373Koch \u4e09\u89d2\u9876\u70b9\u5904(\u56fe6 – 1 – 1)\u3002\u7ec4\u7ec7\u5b66 \u4e0a\uff0c\u623f\u5ba4\u7ed3\u4ea4\u754c\u533a\u6709\u4e09\u7ec4\u7ec6\u80de\u7ec4\u6210\uff1a\u2460\u5fc3\u623f\u808c\u548c\u771f\u6027\u623f\u5ba4\u7ed3\u4e4b\u95f4\u7684\u79fb\u884c\u7ec6\u80de\u3002\u2461\u771f\u6027 \u623f\u5ba4\u7ed3\u533a\u3002\u2462\u819c\u90e8\u95f4\u9694\u7684\u675f\u533a\u3002<\/p>\n

\u623f\u5ba4\u7ed3\u7684\u4f9b\u8840\u4e3b\u8981\u6765\u81ea\u623f\u5ba4\u7ed3\u52a8\u8109\uff0c\u540e\u800590%\u7531\u53f3\u51a0\u72b6\u52a8\u8109\u53d1\u51fa\u3002<\/p>\n<\/p>\n

(\u5f15\u81eaShoei K.Stephen Huang\u7b49\u7f16\u8457 Catheter Ablation of Cardiac Arrhythmias \u7b2c\u4e09\u7248)<\/p>\n

\u623f\u5ba4\u7ed3\u6298\u8fd4\u7684\u7535\u751f\u7406\u673a\u5236<\/p>\n

\u4e00\u3001\u623f\u5ba4\u7ed3\u53cc\u5f84\u8def\u53ca\u591a\u8def\u5f84<\/p>\n

\u65e9\u57281913\u5e74\uff0cMines \u7b49\u5c31\u63d0\u51fa\u623f\u5ba4\u7ed3\u5185\u53ef\u80fd\u5b58\u5728\u4e24\u6761\u7279\u5b9a\u4f20\u5bfc\u533a\u57df\uff0c\u5176\u4f20\u5bfc\u53ca\u6062 \u590d\u5747\u4e0d\u76f8\u540c\u3002\u540e\u6765Moe \u7b49\u7684\u7814\u7a76\u8bc1\u5b9e\u4e86\u623f\u5ba4\u7ed3\u6298\u8fd4\u7684\u673a\u5236\u5728\u4e8e\u623f\u5ba4\u7ed3\u5185\u4f20\u5bfc\u53ca\u4e0d\u5e94 \u671f\u8fe5\u5f02\u7684\u4e24\u6761\u4f20\u5bfc\u8def\u5f84\u3002\u5176\u4e2d\u5feb\u5f84(\u03b2\u5f84\u8def)\u7684\u4f20\u5bfc\u901f\u5ea6\u5feb\uff0c\u4f46\u4e0d\u5e94\u671f\u8f83\u957f\uff1b\u800c\u6162 \u5f84(\u03b1\u5f84\u8def)\u7684\u4f20\u5bfc\u901f\u5ea6\u6162\uff0c\u4f46\u4e0d\u5e94\u671f\u8f83\u77ed\u3002\u8fd9\u4e24\u6761\u4f20\u5bfc\u8def\u5f84\u7684\u4e0d\u540c\u7535\u751f\u7406\u7279\u6027\u662f AVNRT\u53d1\u751f\u53ca\u7ef4\u6301\u7684\u57fa\u7840\u3002<\/p>\n

\u968f\u7740\u4e34\u5e8a\u53ca\u57fa\u7840\u7814\u7a76\u7684\u4e0d\u65ad\u6df1\u5165\uff0c\u76ee\u524d\u8ba4\u4e3a\u623f\u5ba4\u7ed3\u53cc\u5f84\u8def\u7684\u53d1\u751f\u7387\u5f88\u9ad8\uff0c\u5728\u6b63\u5e38 \u4eba\u7fa4\u4e2d\uff0c\u4ea6\u53ef\u8fd150%\uff5e77%\u3002\u5e94\u7528\u5fc3\u623f\u7a0b\u5e8f\u65e9\u640f\u523a\u6fc0\u53ef\u4ee5\u68c0\u6d4b\u51fa\u623f\u5ba4\u7ed3\u53cc\u5f84\u8def\u4f20\u5bfc \u73b0\u8c61\u3002\u5fc3\u623f\u671f\u524d\u523a\u6fc0(\u226410ms)  \u65f6\uff0c\u623f\u5e0c\u4f20\u5bfc\u65f6\u95f4\u5373AH \u95f4\u671f\u8df3\u8dc3\u503c\u5927\u4e8e50ms \u5373 \u8ba4 \u4e3a\u5b58\u5728\u623f\u5ba4\u7ed3\u53cc\u5f84\u8def\u3002\u5e94\u7528\u5fc3\u623f\u671f\u524d\u523a\u6fc0\u7684\u8054\u5f8b\u95f4\u671f\u503c\u4e0e\u623f\u5ba4\u7ed3\u4f20\u5bfc\u65f6\u95f4\u505a\u4e00\u4e2a\u66f2\u7ebf\u56fe\uff0c\u5219\u53ef\u663e\u793a\u623f\u5ba4\u7ed3\u524d\u5411\u4f20\u5bfc\u529f\u80fd\u3002\u968f\u7740\u5fc3\u623fS1S2 \u671f\u524d\u9012\u51cf\u523a\u6fc0\uff0c\u4e00\u65e6 AH \u95f4\u671f\u8df3 \u8dc3\u5927\u4e8e50ms \u65f6\u5373\u8868\u73b0\u51fa\u623f\u5ba4\u7ed3\u524d\u5411\u4f20\u5bfcAH \u66f2\u7ebf\u7684\u4e2d\u65ad(\u56fe6- 1- 2)\u3002<\/p>\n<\/p>\n

\u56fe6-1-2 \u7ecf\u6162\u5f84\u4f20\u5bfc\u5e76\u8bf1\u53d1\u5ba4\u4e0a\u901f\u7684\u4e34\u754cAH\u95f4\u671f\u3002\u6a2a\u5750\u6807\u4e3a\u5fc3\u623f\u671f\u524d\u523a\u6fc0\u7684\u8054\u5f8b\u95f4\u671f\u503c(A1A2),\u7eb5\u5750\u6807\u4e3a\u623f\u5ba4\u7ed3\u4f20\u5bfc\u65f6\u95f4(A2-H2)\u3002\u5f53\u5fc3\u623fA1A2\u95f4\u671f\u9012\u51cf\u81f3480ms\u65f6\uff0c\u5feb\u5f84\u4f20\u5bfc\u53d7\u963b\uff0c\u4f46\u5e76\u672a\u8bf1\u53d1\u5ba4\u4e0a\u901f\u3002\u5f53A2H2\u95f4\u671f\u4e3a275ms\u65f6\uff0c\u624d\u8bf1\u53d1\u4e86\u5fc3\u52a8\u8fc7\u901f\u3002\u56fe\u4e2d\u53ef\u89c1A1A2\u95f4\u671f\u9012\u51cf\u81f3380ms\u65f6\uff0cAH \u4f20\u5bfc\u66f2\u7ebf\u4e2d\u65ad\uff0c\u8df3\u8dc3\u503c\u5927\u4e8e50ms\u3002 (\u5f15\u81eaMark E.Josephson\u7f16\u8457\u7684Josephson’S Clinical Cardiac Electrophysiology Techniques and interpretations FIFTH EDITION)<\/p>\n

\u623f\u5ba4\u7ed3\u9006\u5411\u4f20\u5bfc\u529f\u80fd\u4e5f\u53ef\u901a\u8fc7\u5fc3\u5ba4\u671f\u524d\u523a\u6fc0\u7684\u5ba4\u623f\u4f20\u5bfc\u66f2\u7ebf\u53cd\u6620\u51fa\u6765\uff1b\u5f53\u5fc3\u5ba4 S1S2\u523a\u6fc0\u9012\u51cf\u81f3\u67d0\u4e00\u914d\u5bf9\u95f4\u671f\u65f6\uff0cVA \u95f4\u671f\u7684\u5ef6\u957f\u8df3\u8dc3\u503c\u5927\u4e8e50ms \u5373\u53ef\u8bc1\u5b9e\u623f\u5ba4\u7ed3 \u9006\u4f20\u5b58\u5728\u53cc\u5f84\u8def\u73b0\u8c61\u3002\u6709\u5b66\u8005\u53d1\u73b0\uff0c\u5f53\u5ba4\u623f\u9006\u4f20\u7531\u5feb\u5f84\u8f6c\u5411\u6162\u5f84\u65f6\uff0c\u5176\u5fc3\u623f\u6fc0\u52a8\u7684\u987a \u5e8f\u4ea6\u53d1\u751f\u6539\u53d8\uff1b\u6700\u65e9\u7684\u5fc3\u623f\u6fc0\u52a8\u70b9 (EAA)   \u7531\u5e0c\u6c0f\u675f\u8f6c\u81f3\u51a0\u72b6\u9759\u8109\u7aa6\u53e3\u3002<\/p>\n

\u5fc3\u623f\u671f\u524d\u523a\u6fc0\u65f6\uff0c\u82e5 AH\u95f4\u671f\u5ef6\u957f\u51fa\u73b0\u591a\u6b21\u5927\u4e8e50ms \u7684\u8df3\u8dc3\u65f6\u5219\u53ef\u8003\u8651\u5b58\u5728\u623f \u5ba4\u7ed3\u7684\u591a\u5f84\u8def\u3002\u8fd15%\uff5e10%\u7684\u623f\u5ba4\u7ed3\u53cc\u5f84\u8def\u60a3\u8005\u5408\u5e76\u5b58\u5728\u591a\u5f84\u8def\u3002<\/p>\n

\u4ee5\u5f80\u7684\u89c2\u70b9\u8ba4\u4e3a\u623f\u5ba4\u7ed3\u53cc\u5f84\u8def\u7684\u7ec4\u7ec7\u5b66\u57fa\u7840\u5728\u4e8e\u623f\u5ba4\u7ed3\u5185\u7ec4\u7ec7\u7ec6\u80de\u7684\u7eb5\u5411\u5206\u79bb\u3002 \u4f46\u8fd1\u6765\u7684\u7814\u7a76\u53d1\u73b0\uff0c\u623f\u5ba4\u7ed3\u79fb\u884c\u7ec6\u80de\u7684\u5404\u5411\u5f02\u6027\u4f20\u5bfc\u6216\u7535\u5f20\u529b\u6539\u53d8\u53ef\u80fd\u662f\u623f\u5ba4\u7ed3\u53cc\u5f84 \u8def\u7684\u4e3b\u8981\u53d1\u751f\u57fa\u8d28\u3002\u623f\u5ba4\u7ed3\u7684\u7ed3\u6784\u590d\u6742\uff0c\u5176\u79fb\u884c\u90e8\u5206\u53ef\u5ef6\u4f38\u81f3\u53f3\u623f\u548c\u5de6\u623f\uff0c\u5728\u81f4\u5bc6\u7684 \u771f\u6027\u623f\u5ba4\u7ed3\u5185\u7ec6\u80de\u95f4\u5b58\u5728\u7f1d\u9699\u8fde\u63a5\uff0c\u7ec4\u7ec7\u95f4\u591a\u5448\u7eb5\u5411\u6392\u5217\uff0c\u7f3a\u4e4f\u4fa7\u4fa7\u8fde\u63a5\uff0c\u8fd9\u4e5f\u662f\u5bb9 \u6613\u53d1\u751f\u4f20\u5bfc\u4e0d\u5747\u4e00\u5404\u5411\u5f02\u6027\u7684\u539f\u56e0\u3002<\/p>\n

\u4e8c\u3001\u623f\u5ba4\u7ed3\u6298\u8fd4\u7684\u7c7b\u578b<\/p>\n

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1. \u6162 \u5feb \u578b AVNRT<\/p>\n

\u53c8\u79f0\u7ecf\u5178\u578b\u6216\u5e38\u89c1\u578b\uff0c\u662fAVNRT\u6700\u4e3a\u5e38\u89c1\u7684\u7c7b\u578b\uff0c\u7ea6\u536090%\u3002\u5f53\u4e00\u4e2a\u9002\u65f6\u7684\u623f<\/p>\n

\u6027\u65e9\u640f\u4e0b\u4f20\u65f6\uff0c\u7531\u4e8e\u4f20\u5bfc\u901f\u5ea6\u8f83\u5feb\u7684\u03b2\u5f84\u8def\u56e0\u5176\u4e0d\u5e94\u671f\u8f83\u957f\u6545\u4f20\u5bfc\u53d7\u963b\uff1b\u800c\u4f20\u5bfc\u901f \u5ea6\u8f83\u4e3a\u7f13\u6162\u7684\u03b1\u5f84\u8def\u56e0\u5176\u4e0d\u5e94\u671f\u8f83\u77ed\u6545\u800c\u6fc0\u52a8\u5f97\u4ee5\u7ee7\u7eed\u4e0b\u4f20\uff1b\u5f53\u6fc0\u52a8\u4f20\u5bfc\u81f3\u6162\u5f84\u4e0b \u7aef\u65f6\uff0c\u5feb\u5f84\u5df2\u6062\u590d\u5174\u594b\u6027\uff0c\u6b64\u65f6\u6fc0\u52a8\u5219\u6cbf\u5feb\u5f84\u9006\u4f20\u81f3\u5fc3\u623f\u4ea7\u751f\u5fc3\u623f\u56de\u6ce2\uff0c\u540c\u65f6\u6fc0\u52a8\u518d \u6cbf\u6162\u5f84\u4e0b\u4f20\uff0c\u5982\u6b64\u5468\u800c\u590d\u59cb\u53d1\u751fAVNRT  (\u56fe6 – 1 – 3)\u3002<\/p>\n<\/p>\n

\u56fe6-1-3 \u4e3a\u6162\u5feb\u578b\u623f\u5ba4\u7ed3\u6298\u8fd4\u7684\u793a\u610f\u56fe<\/p>\n

(\u5f15\u81eaMarkE.Josephson \u7f16\u8457\u7684Josephson’S Clinical Cardiac Electrophysiology Techniques and interpretations FIFTH EDITION)<\/p>\n

\u7ecf\u5178\u578b\u5373\u6162\u5feb\u578bAVNRT\u5728\u5fc3\u5185\u7535\u751f\u7406\u68c0\u67e5\u65f6\uff0c\u6709\u4ee5\u4e0b\u7279\u5f81\uff1a<\/p>\n

(1)\u623f\u5ba4\u7ed3\u524d\u4f20\u7684\u8df3\u8dc3\u73b0\u8c61\uff0c\u5373\u5fc3\u623f\u671f\u524d\u7a0b\u5e8f\u523a\u6fc0\u65f6\uff0cAH \u95f4\u671f\u5ef6\u957f\u8df3\u8dc3\u503c\u5927 \u4e8e50ms\u3002<\/p>\n

(2)\u5fc3\u623f\u6fc0\u52a8\u5448\u79bb\u5fc3\u6027\u6269\u5e03\uff0c\u6700\u65e9\u7684\u5fc3\u623f\u6fc0\u52a8\u70b9\u4f4d\u4e8e\u5e0c\u6c0f\u675f\u3002<\/p>\n

(3)\u5fc3\u52a8\u8fc7\u901f\u53d1\u4f5c\u65f6\uff0c\u5fc3\u5ba4\u62d6\u5e26\u540e\u7684\u5fc3\u623f\u6fc0\u52a8\u987a\u5e8f\u8868\u73b0\u4e3aV-A-V     \u5173\u7cfb\u3002<\/p>\n

(4)\u5fc3\u52a8\u8fc7\u901f\u65f6\uff0c\u623f\u5ba4\u540c\u6b65\u6fc0\u52a8HA\u95f4\u671f\u8f83\u77ed(\u901a\u5e38\u5c0f\u4e8e60ms)\u3002<\/p>\n

(5)\u5fc3\u52a8\u8fc7\u901f\u65f6\u5728\u5e0c\u6c0f\u675f\u4e0d\u5e94\u671f\u5185\u5f15\u5165\u5ba4\u6027\u671f\u524d\u523a\u6fc0\uff0c\u4e0d\u4f1a\u91cd\u6574\u5fc3\u623f\u6fc0\u52a8\uff1b\u5728 \u8131\u79bb\u5e0c\u6c0f\u675f\u4e0d\u5e94\u671f\u540e\u5f15\u5165\u5fc3\u5ba4\u65e9\u640f\u523a\u6fc0\u65f6\uff0c\u5fc3\u623f\u53ef\u88ab\u6fc0\u52a8\uff0c\u4f46\u6fc0\u52a8\u987a\u5e8f\u4e0eAVNRT \u76f8\u540c\u3002<\/p>\n

(6)\u5fc3\u52a8\u8fc7\u901f\u53d1\u4f5c\u65f6\u623f\u5ba4\u591a\u4e3a1:1\u5173\u7cfb\uff0c\u5c11\u6570\u60c5\u51b5\u4e0b\u53ef\u5448\u6587\u6c0f\u30012:1\u6216\u5b8c\u5168 \u5206\u79bb\u3002<\/p>\n

\u5c0f\u90e8\u5206AVNRT\u60a3\u8005\uff0c\u5176\u623f\u5ba4\u7ed3\u524d\u4f20AH\u66f2\u7ebf\u5149\u6ed1\u5e76\u65e0\u4f20\u5bfc\u4e2d\u65ad\u8df3\u8dc3\u73b0\u8c61\u3002\u53ef\u80fd \u7684\u539f\u56e0\u6709\uff1a\u2460\u623f\u5ba4\u7ed3\u5feb\u3001\u6162\u5f84\u7684\u4e0d\u5e94\u671f\u76f8\u8fd1\uff0c\u5e94\u7528\u963f\u6258\u54c1\u6216\u5f02\u4e19\u80be\u4e0a\u817a\u7d20\u53ef\u663e\u9732\u53cc\u5f84 \u8def\u3002\u2461\u523a\u6fc0\u90e8\u4f4d\u7684\u5fc3\u623f\u529f\u80fd\u4e0d\u5e94\u671f\u8f83\u957f\uff0c\u5f71\u54cd\u4e86\u914d\u5bf9\u95f4\u671f\u66f4\u77ed\u7684\u5fc3\u623f\u671f\u524d\u523a\u6fc0\u8fdb\u5165\u623f \u5ba4\u7ed3\u3002\u2462\u5feb\u3001\u6162\u5f84\u7684\u4f20\u5bfc\u65f6\u95f4\u76f8\u5dee\u8f83\u5c0f\u3002<\/p>\n

\u6781\u5c11\u6570\u60a3\u8005\u5728\u7aa6\u5f8b\u6216\u5fc3\u623f\u523a\u6fc0\u65f6\uff0c\u53ef\u8868\u73b0\u4e3a\u5fc3\u5ba4\u53cc\u91cd\u53cd\u5e94\u62161:2\u73b0\u8c61\u3002<\/p>\n

2. \u5feb\u6162\u578bAVNRT<\/p>\n

\u53c8\u79f0\u5c11\u89c1\u578b\u6216\u4e0d\u5178\u578b\uff0c\u7ea6\u5360AVNRT\u76845%\uff5e10%\u3002\u5feb\u5f84\u4f20\u5bfc\u5feb\u4e14\u4e0d\u5e94\u671f\u77ed\uff0c\u6162 \u5f84\u4f20\u5bfc\u901f\u5ea6\u6162\u4e14\u4e0d\u5e94\u671f\u957f\u3002\u6545\u800c\u6fc0\u52a8\u6cbf\u5feb\u5f84\u4e0b\u4f20\uff0c\u5f85\u6fc0\u52a8\u4f20\u5bfc\u81f3\u5feb\u5f84\u4e0b\u7aef\u65f6\uff0c\u6162\u5f84\u7684 \u5174\u594b\u6027\u6062\u590d\uff0c\u6fc0\u52a8\u5219\u6cbf\u6162\u5f84\u9006\u4f20\uff1b\u5982\u6b64\u53cd\u590d\u5f62\u6210\u6298\u8fd4\u3002<\/p>\n

\u5c11\u89c1\u578bAVNRT\u5177\u6709\u4ee5\u4e0b\u7535\u751f\u7406\u7279\u70b9\uff1a<\/p>\n

(1)\u5fc3\u52a8\u8fc7\u901f\u65f6\u7684 AH\u95f4\u671f\u8f83\u77ed(<180ms)\u3002 ( 2 ) \u957fRP \u578b\u5fc3\u52a8\u8fc7\u901f\uff0c\u4e0b\u58c1\u5bfc\u8054P \u6ce2\u5012\u7f6e\u3002<\/p>\n

(3)\u5fc3\u52a8\u8fc7\u901f\u7684\u8bf1\u53d1\u4f9d\u8d56\u4e8e\u67d0\u4e00\u7279\u5b9a HA\u95f4\u671f\u5373\u6240\u8c13\u7684\u5ba4\u623f\u4f20\u5bfc\u201c\u5f00\u5173\u201d\u73b0\u8c61\u3002<\/p>\n

(4)\u5fc3\u52a8\u8fc7\u901f\u65f6\uff0c\u6700\u65e9\u7684\u5fc3\u623f\u6fc0\u52a8\u70b9\u4f4d\u4e8e\u51a0\u72b6\u9759\u8109\u7aa6\u53e3\u6216\u9644\u8fd1\u3002<\/p>\n

(5)\u5fc3\u52a8\u8fc7\u901f\u65f6\u5728\u5e0c\u6c0f\u675f\u4e0d\u5e94\u671f\u5185\u5f15\u5165\u5ba4\u6027\u671f\u524d\u523a\u6fc0\uff0c\u4e0d\u4f1a\u91cd\u6574\u5fc3\u623f\u6fc0\u52a8\uff1b\u5728 \u8131\u79bb\u5e0c\u6c0f\u675f\u4e0d\u5e94\u671f\u540e\u5f15\u5165\u5fc3\u5ba4\u65e9\u640f\u523a\u6fc0\u65f6\uff0c\u5fc3\u623f\u53ef\u88ab\u6fc0\u52a8\uff0c\u4f46\u6fc0\u52a8\u987a\u5e8f\u4e0d\u53d8\u3002<\/p>\n

(6)\u4ee5\u5fc3\u52a8\u8fc7\u901f\u76f8\u540c\u7684\u5468\u957f\u8d77\u640f\u5fc3\u5ba4\uff0c\u5176HA\u95f4\u671f\u5927\u4e8e\u5fc3\u52a8\u8fc7\u901f\u7684HA\u95f4 \u671f ( \u4e0b \u90e8\u5171\u5f84)\u3002<\/p>\n

(7)\u4ee5\u5fc3\u52a8\u8fc7\u901f\u76f8\u540c\u7684\u5468\u957f\u8d77\u640f\u5fc3\u623f\uff0c\u5176AH \u95f4\u671f\u5927\u4e8e\u5fc3\u52a8\u8fc7\u901fAH \u95f4\u671f\u81f3\u5c11 40ms \u4ee5\u4e0a\u3002<\/p>\n

\u4e5f\u6709\u5b66\u8005\u53d1\u73b0\u5feb\u6162\u578bAVNRT\u7684\u6700\u65e9\u5fc3\u623f\u6fc0\u52a8\u70b9\u4f4d\u4e8e Koch \u9876\u70b9\u9644\u8fd1\u6216\u4e3b\u52a8\u8109\u65e0 \u51a0\u7aa6\uff0c\u63a8\u6d4b\u662f\u5176\u4e0a\u90e8\u4e9a\u578b\uff1b\u4f46\u5c1a\u672a\u88ab\u80af\u5b9a\u3002<\/p>\n

3 .\u6162\u6162\u578b AVNRT<\/p>\n

\u662f\u4e00\u79cd\u7279\u6b8a\u7c7b\u578b\uff0c\u662f\u4e24\u6761\u6162\u5f84\u4e4b\u95f4\u7684\u6298\u8fd4\uff0c\u5c5e\u4e8e\u623f\u5ba4\u7ed3\u591a\u5f84\u8def\u3002\u5feb\u5f84\u7531\u4e8e\u6ca1\u6709\u9006 \u4f20\u6216\u9006\u4f20\u529f\u80fd\u8f83\u5dee(\u4e0d\u5e94\u671f\u8f83\u957f),\u6545\u800c\u5e76\u4e0d\u53c2\u4e0e\u5fc3\u52a8\u8fc7\u901f\u7684\u5f62\u6210\uff0c\u4ec5\u4ec5\u4f5c\u4e3a\u6fc0\u52a8\u7684 \u201c\u65c1\u89c2\u8005\u201d\u3002\u4e34\u5e8a\u4ea6\u53d1\u73b0\u6b64\u7c7b\u60a3\u8005\u901a\u5e38\u53ef\u5408\u5e76\u591a\u79cdAVNRT\u3002<\/p>\n

\u6162\u6162\u578bAVNRT\u7684\u7535\u751f\u7406\u7279\u70b9\u6709\uff1a<\/p>\n

(1)\u9664\u6700\u65e9\u9006\u4f20\u5fc3\u623f\u6fc0\u52a8\u70b9\u4f4d\u4e8e\u51a0\u72b6\u9759\u8109\u7aa6\u53e3\u5916\uff0c\u5176\u4ed6\u8868\u73b0\u7c7b\u540c\u6162\u5feb\u578bAVNRT\u3002<\/p>\n

(2)\u5fc3\u52a8\u8fc7\u901f\u7684\u8bf1\u53d1\u4f9d\u8d56\u4e8e\u6162\u5f84\u9006\u4f20\u65f6\u7684\u67d0\u4e00\u7279\u5b9a HA\u95f4\u671f\u3002<\/p>\n

(3)\u4ee5\u5fc3\u52a8\u8fc7\u901f\u76f8\u540c\u7684\u5468\u957f\u8d77\u640f\u5fc3\u5ba4\uff0c\u5176HA \u95f4\u671f\u5927\u4e8e\u5fc3\u52a8\u8fc7\u901f\u7684 HA \u95f4 \u671f ( \u4e0b \u90e8\u5171\u5f84)\u3002<\/p>\n

4.\u5de6 \u4fa7AVNRT<\/p>\n

\u7ea6\u5360 AVNRT \u60a3\u8005\u76841.5%\u5de6\u53f3\u3002\u5176\u4f53\u8868\u5fc3\u7535\u56fe\u53ca\u5fc3\u5185\u7535\u751f\u7406\u7279\u70b9\u4e0e\u7ecf\u5178\u578b  AVNRT\u5e76\u65e0\u4e0d\u540c\uff0c\u4e34\u5e8a\u8868\u73b0\u4e5f\u65e0\u7279\u6b8a\u3002\u4ec5\u4ec5\u662f\u5728\u5e38\u89c4\u53f3\u4fa7\u6d88\u878d\u623f\u5ba4\u7ed3\u6162\u5f84\u65e0\u6548\u540e\uff0c \u5728\u5de6\u623f\u6216\u51a0\u72b6\u9759\u8109\u7aa6\u5185\u6d88\u878d\u6210\u529f\u5f97\u4ee5\u8bc1\u5b9e\u3002\u5176HA\u95f4\u671f\u901a\u5e38\u5f88\u77ed(\u226415ms) \u3002\u90e8\u5206\u75c5 \u4eba\u5728\u5fc3\u623f\u523a\u6fc0\u65f6\uff0c\u53ef\u8868\u73b0\u4e3a\u53cc\u91cd\u5fc3\u5ba4\u53cd\u5e94\u3002\u5de6\u4fa7AVNRT \u8005\u5176AH\u95f4\u671f\u53ca\u5fc3\u52a8\u5468\u957f\u8f83  \u53f3\u4fa7\u6162\u5feb\u578bAVNRT\u8005\u8981\u957f\u3002<\/p>\n

\u4e09 \u3001\u5fc3 \u623f \u548c \u5fc3 \u5ba4 \u4e0d \u662fAVNRT   \u6298\u8fd4\u73af\u7684\u5fc5\u8981\u7ec4\u6210<\/p>\n

\u957f\u671f\u4ee5\u6765\uff0c\u6709\u5173\u5fc3\u623f\u548c\u5fc3\u5ba4\u662f\u5426\u662f\u623f\u5ba4\u7ed3\u6298\u8fd4\u73af\u7684\u5fc5\u8981\u7ec4\u6210\u6210\u5206\u4ee5\u53ca\u662f\u5426\u5b58\u5728\u623f<\/p>\n

\u5ba4\u7ed3\u4e0a\u90e8\u53ca\u4e0b\u90e8\u5171\u5f84\u7b49\u95ee\u9898\u4e00\u76f4\u5b58\u6709\u4e89\u8bae(\u56fe6-1-4)\u3002<\/p>\n<\/p>\n

\u56fe6 – 1 – 4 \u623f\u5ba4\u7ed3\u6298\u8fd4\u7684\u4e0a\u90e8\u53ca\u4e0b\u90e8\u5171\u5f84\u793a\u610f\u56fe\u3002<\/p>\n

(\u5f15\u81eaMarkE.Josephson\u7f16\u8457\u7684Josephson’S Clinical Cardiac Electrophysiology Techniques and interpretations FIFTH EDITION)<\/p>\n

\u968f\u7740\u5bfc\u7ba1\u5c04\u9891\u6d88\u878d\u53ca\u7535\u751f\u7406\u7814\u7a76\u7684\u6df1\u5165\uff0c\u73b0\u5df2\u660e\u786e\u89e3\u5256\u5b66\u4e0a\u7684\u771f\u6027\u623f\u5ba4\u7ed3\u4e0e\u7535\u751f \u7406\u623f\u5ba4\u7ed3\u7684\u6982\u5ff5\u53ca\u533a\u57df\u5e76\u4e0d\u4e00\u81f4\uff0c\u540e\u8005\u7684\u8303\u56f4\u6db5\u76d6\u7ed3\u5468\u7684\u5fc3\u623f\u7ec4\u7ec7\u3002\u7ec4\u7ec7\u5b66\u53d1\u73b0\u7ed3\u5468 \u5fc3\u623f\u7ec4\u7ec7\u662f\u7531\u79fb\u884c\u7ec6\u80de\u7ec4\u6210\uff0c\u4e0e\u6b63\u5e38\u7684\u5fc3\u623f\u808c\u7ec4\u7ec7\u4e0d\u540c\u3002\u5916\u79d1\u624b\u672f\u5206\u79bbKoch\u4e09\u89d2\u9876 \u90e8\u3001\u51b7\u51bb\u6d88\u878d\u771f\u6027\u623f\u5ba4\u7ed3\u5468\u5fc3\u623f\u7ec4\u7ec7\u3001\u5bfc\u7ba1\u5c04\u9891\u6d88\u878d\u51a0\u72b6\u9759\u8109\u7aa6\u53e3\u4e0a\u65b9\u5747\u53ef\u6839\u6cbb AVNRT\u3002\u8fd9\u8bf4\u660e\u7ed3\u5468\u7ec4\u7ec7\u53c2\u4e0e\u623f\u5ba4\u7ed3\u7684\u6298\u8fd4\u3002\u90e8\u5206AVNRT\u53d1\u4f5c\u8fc7\u7a0b\u4e2d\uff0c\u53ef\u4ee5\u51fa\u73b0\u5ba4 \u623f\u9006\u4f20\u6587\u6c0f\u62162:1\u963b\u6ede(\u56fe6-1-5),AVNRT \u4ea6\u53ef\u7531\u5fc3\u623f\u6251\u52a8\u6216\u623f\u98a4\u8f6c\u53d8\u800c\u6765(\u56fe 6-1-6);\u540c\u65f6\u4e5f\u53ef\u51fa\u73b0\u623f\u5ba42:1\u4e0b\u4f20(\u56fe6-1-7)<\/p>\n

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