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一、C 题解:急性下壁心肌梗塞合并窦性心动过缓及低血压者,即使出现较为频繁的室性早搏,首选药物仍为静注阿托品,而非利多卡因。阿托品的首次剂量以0.5～0.6毫克为宜,<0.3毫克可能兴奋迷走神经中枢使心率更为减慢,>1毫克则可能引起窦性心动过速,诱发室颤。当注射阿托品心率增至正常范围后,血压亦可升至正常,室性早搏也可随之消失。若血压、心率均恢复正常而室性早搏仍不消失,再考虑采用利多卡因。
A C solution: acute inferior myocardial infarction with sinus bradycardia and hypotension, even if there is more frequent ventricular premature beats, the preferred drug is still intravenous atropine, rather than lidocaine. Atropine for the first dose of 0.5 ~ 0.6 mg is appropriate, <0.3 mg may be excited vagus nerve center to make the heart rate more slowly,> 1 mg may cause sinus tachycardia, induced ventricular fibrillation. When the injection of atropine heart rate increased to the normal range, the blood pressure can rise to normal, ventricular premature beats also disappear. If the blood pressure, heart rate returned to normal ventricular premature beats still did not disappear, then consider the use of lidocaine.