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问题:

风湿性心脏病单纯二尖瓣狭窄,窦性心律伴急性肺水肿,宜选用 A.硝酸甘油静脉点滴 B.硝普钠

风湿性心脏病单纯二尖瓣狭窄,窦性心律伴急性肺水肿,宜选用

A.硝酸甘油静脉点滴

B.硝普钠静脉点滴

C.速尿静脉注射

D.毛花苷C(西地兰)静脉注射


  参考答案

正确答案:AC

141.答案:AC

[考点] 风心病二尖瓣狭窄肺水肿治疗

[分析] 风心病单纯二尖瓣狭窄并发急性肺水肿时应避免使用以扩张小动脉为主,减轻心脏后负荷的血管扩张药物,因它降低外周阻力血管,使血压降低,而此时二尖瓣狭窄使左心房血注入左心室少,左心排血量少,因而易造成低血压甚至休克。故不宜选用硝普钠;而应选用扩张静脉系统、减轻心脏前负荷为主的硝酸酯类药物如硝酸甘油,它可减轻肺淤血、肺水肿;速尿亦可达到此目的,亦应选用;西地兰系加强心肌收缩力的药物,此时非左心室收缩力降低造成的肺水肿,故对减轻肺水肿无益处,但当有伴快速心室率的心房颤动时则可应用以减慢心室率。

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