现将急性心肌梗塞监护及处理中几个问题,介绍如下: 一、加强住院前现场或急诊室的处理 (一)尽早明确诊断:应详细询问病史及体格检查,如疑为急性心肌梗塞应立即做心电图检查,一次心电图改变不大患者要多次心电图追查随诊,并用示波仪连续监测心电图,密切观察心率、心律、血压及末梢循环情况。 (二)一旦明确诊断后作必要急救处理:包括鼻管吸氧,对疼痛病人立即给予镇痛剂,剧痛者首选杜冷丁,必要时注射吗啡,程度较轻者可用罂粟碱;建立静脉通道;如血压,心律通过监护一直乎稳,即可送入病房或监护病房(CCU)。为防止转送病房途中可能发生室性心律失常,可以静脉给50mg利多卡因或送病房前15分钟肌注利多卡因100mg,但对心率慢或有传导阻 Acute myocardial infarction monitoring and treatment of several issues are described below: First, to strengthen the pre-hospital or emergency room treatment (A) as soon as possible a clear diagnosis: history and physical examination should be asked in detail, such as suspected acute myocardial infarction should be immediately Do electrocardiogram examination, a small change in ECG patients to multiple follow-up of ECG follow-up, and continuous monitoring of ECG with an oscilloscope, close observation of heart rate, heart rate, blood pressure and peripheral circulation. (B) once the diagnosis is made necessary for emergency treatment: including nasal tube oxygen, the pain patients immediately given analgesics, pectoris preferred pethidine, if necessary, morphine, papaverine can be used to a lesser extent; the establishment of venous access ; If blood pressure, heart rate through custody has stabilized, can be sent to the ward or intensive care unit (CCU). To prevent the transfer of wards on the way may occur ventricular arrhythmia, intravenous injection of lidocaine 50mg or 15 minutes before the ward to intramuscular lidocaine 100mg, but slow heart rate or resistance