- 期刊
- OpenAccess
【論文摘要】有關頑固型PSVT的案例回顧及處置方法
【論文摘要】The treatment and the cases review of refractory PSVT
摘要
研究背景：陣發性上心室頻脈（paroxysmal supraventricular tachycardia，簡稱PSVT）是心律不整中常見的其中一種類型，其心電圖典型表現為快且窄的QRS波，其心律每分鐘約一百五十到兩百五十次之間。PSVT大多是良性且可以自行緩解的，常被當成心悸帶過。但也有一些PSVT是難以自行緩解的，在處置上會需要以副交感神經刺激術、用藥或同步整律治療。研究方法（或案例描述）：將患有PSVT之患者的處置方式記錄下來，觀察患者在不同的處置進程會有怎麼樣的表現，以及在何種進程就能緩解心搏過速的情形。研究結果（或案例討論）：本文探討的是一位PSVT意識清楚個案，此個案因有呼吸喘、冒冷汗及無力症狀，乃求診於某區域醫院，經心電圖監視器檢查呈現PSVT之波型，患者心律每分鐘約一百八十下，此案例治療過程與ACLS步驟環環相扣，由於此為穩定的患者，決定先執行頸動脈竇按摩術（carotid massage），無效後再分別施打Adenosine、verapamil、Amiodarone，以上藥物皆都無效後，最後決定實施同步整律，同步整律後約10秒，患者心律恢復正常，症狀緩解。
關鍵字
PSVT陣發性心律過速並列摘要
Background: Paroxysmal supraventricular tachycardia (PSVT) is a common type of arrhythmia. Its electrocardiogram typically shows fast and narrow QRS waves, and its heart rate is about 100 per minute. Between 150-250 times. PSVT is mostly benign and can be relieved by itself, and it is often taken as a heart attack. However, there are also some patients with PSVT that are difficult to relieve on their own, and will require parasympathetic nerve stimulation, even use synchronized cardioversion. Methods (Or case presentation): To observe patients who suffered from PSVT and find out the cures for PSVT while we curing these patients. Results (Or Case Discussion): The patient who suffered from PSVT with clear consciousness, but he came to Dalin Tzu Chi ER with a shortness breath, cold sweat and weakness, so immediately, doctor do EKG, and it showed PSVT waves, heart rate 180 per minute. This patients was stable and with clear consciousness, thus the doctor tried carotid massage, and it was useless. After that, doctor tried Adenosine、verapamil、Amiodarone, all of them were useless. Finally, we used synchronized cardioversion, and the patient had a normal sinus rhythm after 10 secs.