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急性心肌梗塞、尤其下壁穿透性梗塞时,识别右室梗塞(RVMI)或受累程度是极其重要的。因其血液动力学改变迥然不同于左室梗塞,故其治疗亦显著相殊。RVMI合并心源性休克不应用利尿剂和血管扩张药,因有进一步降低左室充盈压,因而降低心输出量,进一步加重休克;而应采用积极慎重的容量扩张疗法(如静滴生理盐水150毫升/小时试验治疗),以提高右心、左室的充盈压,改善心输出量。
In acute myocardial infarction, especially in the case of penetrating infarcts in the inferior wall, it is of paramount importance to identify right ventricular infarction (RVMI) or degree of involvement. Because of its hemodynamic changes are very different from left ventricular infarction, so the treatment is also significantly different. RVMI combined with cardiogenic shock does not use diuretics and vasodilators, as further reduce the left ventricular filling pressure, thereby reducing cardiac output, further aggravating shock; and should be used to positive and careful capacity expansion therapy (such as intravenous infusion of saline 150 Ml / h test treatment), to improve the right heart, left ventricular filling pressure, improve cardiac output.