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过早搏动是由心脏异位兴奋灶发放的冲动所引起，为小儿时期最常见的心律失常。异位起波点可位于心房，房室交界或心室组织。分别引起房性、交界性及室性早搏其中以室性早搏为多见。 病因：常见于无器质性心脏病的小儿。可有哭闹、精神紧张、植物神经功能不稳定等引起。 小儿症状较成人为轻，常缺乏主诉，个别年长儿可叙述心悸、胸闷、不适。早搏次数因人而异，同一患儿在不同时间亦可有较大出入。某些患儿于运动后心率增快时早搏减少，但也有反而增多者。后者提示可能同时有器质性心脏病存在的可能。为了明确诊断，了解早搏的性质，必须作心电图检查。 心电图的诊断： 根据心电图有无P，波的存在、P，波的形态、P—R进期长短以及QRS波的形态来判断早搏属于何种类型。 1．房性早搏的心电图特征 （1）P，波提前，可与前一心动的T波重叠；（2）P，—R间期在正常范围；（3）早搏后代偿间隙不完全；（4）如伴有变形的QRS波则为心室内差异传导所致。 2．交界性早搏的心电图特征 （1）QRS波提琴，形态、时限与正常窦性基本相同；（2）早搏所产生的QRS波前或后有逆行P，波，P，—R＜0.10s，有时P，波可与QRS波重叠，而辨认不清；（3）代偿间歇往往不完全。 3．室性早搏的心电图特征 （1）QRS波提前，其前无异位P波；（2）QRS波宽大、畸形、T波与主波方向相反；（3）早搏后多伴有完全代偿间歇。 必须针对基本病因治疗原发病，一般认为若早搏次数不多，无自觉症状，或早搏虽频发呈联律性，但形态一致，活动后减少或消失则不需无特需用药治疗。 游客，如果您要查看本帖隐藏内容请回复 [ 本帖最后由 新月如烟 于 2009-5-17 18:50 编辑 ] |
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