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急性心肌梗塞是内科的常见病、急重症,是引起猝死的主要原因,止痛是治疗的一个重要方面,不仅是减轻痛苦,还因为疼痛使交感神经兴奋性增高,儿茶酚胺分泌量增多,使心肌耗氧量增多,至诱发室颤或室速,导致猝死,所以快速有效的止痛是治疗成功的关键,从临床的工作中总结如下。1.麻醉止痛剂 对坏死组织引起的疼痛止痛效果好。一旦确诊为心肌梗塞应及时应用,应在24小时内止痛,而又不能成瘾。可选用吗啡10mg或杜冷丁100mg im或iv,对前壁心梗并心率过快或有呼吸困难者宜选用吗啡5mgiv,也可以每次3mg,10分钟后可重复共3次,下壁心梗合并心动过缓宜用杜冷丁100mg iv,半小时后可重复,一般用4次。
Acute myocardial infarction is a common medical condition, acute and severe, is the main cause of sudden death, pain is an important aspect of treatment, not only to reduce the pain, but also because of pain increased sympathetic excitability, increased catecholamine secretion, the myocardial consumption Increased oxygen to induce ventricular fibrillation or ventricular tachycardia, leading to sudden death, so fast and effective analgesic is the key to the success of the treatment, concluded from the clinical work is as follows. 1. Anesthetic painkillers cause painful necrotic tissue analgesic effect. Once diagnosed with myocardial infarction should be promptly applied, should be within 24 hours of pain, but can not addiction. Optional morphine 10mg or pethidine 100mg im or iv, and the anterior wall myocardial infarction and heart rate too fast or have difficulty breathing should use morphine 5mgiv, can also be 3mg each 10 minutes after repeated a total of 3 times, inferior wall myocardial infarction Combination of bradycardia with pethidine 100mg iv, half an hour after repeated, usually with 4 times.