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1 病例报告 例1:男,60岁,左下肢阵发性剧痛伴腹痛、恶心、呕吐半天,门诊以“胃炎’、“下肢纤维织炎”收入院。患者既往有高血压史,未经系统治疗。入院前1天和别人口角后饮酒约250ml,电扇吹着睡一夜,第二天早晨发现左下肢阵发性憋胀性剧痛,由大腿向下放散,同时伴腹痛、恶心、呕吐,每次发作大约5～10分钟,共发作2次而急速来院求治,查T36.8℃,P88次/分,BP21.3/13.0kPa,心脏向左下扩大,心率88次/分,心律整,两肺(一),腹部平软,上腹部有轻压痛,肝脾(一),左下肢肤色正常,活动自如。股动脉、足背动脉搏动无减弱。心电图发现V_(3～5)为QR波,Q波深4mm,宽0.04秒,S-T段抬高4～5mm,和T波融合成单向曲线,血WBC12.4×10~9/L,ESR25mm/h,ch8.5mmol/L,TG2.0mmol/L,COT1.2μmol·s~(-1)/L,LDH10.88μmol·s~(-1)/L,最后诊断为急性前壁心肌梗塞~(1-3),立即采用AMI的治疗方案,如吸氧、止痛、β—受体阻滞剂、硝酸甘油等治疗后,症状很快缓解、消失,动态观察心电图变化附合AMI的心电图演变过程。最后痊愈出院。
1 case report Example 1: Male, 60 years old, left lower extremity paroxysmal pain accompanied by abdominal pain, nausea, vomiting half a day, outpatient to “gastritis”, “lower limb fibrosis” income hospital patients with prior history of hypertension without Systemic treatment. One day before admission and after drinking about 250ml mouth population, the fans blown to sleep the next morning found the left lower extremity paroxysmal bloating pain, down from the thigh, accompanied by abdominal pain, nausea, vomiting , Each episode of about 5 to 10 minutes, a total of 2 times and quickly to the hospital for treatment, check T36.8 ℃, P88 beats / min, BP21.3 / 13.0kPa, heart to the left under the expansion of heart rate 88 beats / min, heart rhythm , Both lungs (a), the abdomen is soft, mild tenderness in the abdomen, liver and spleen (a), the left lower extremity skin color is normal, freedom of movement.The femoral artery, dorsalis pedis artery pulsatility without attenuation.VEGF found V_ (3 ~ 5) QR wave, Q wave depth 4mm, width 0.04s, ST elevation 4 ~ 5mm, and T wave into a unidirectional curve, blood WBC12.4 × 10 ~ 9 / L, ESR25mm / h, ch8.5mmol / TG 2.0mmol / L, COT1.2μmol · s -1 / L, LDH10.88μmol·s -1 / L, the final diagnosis of acute anterior myocardial infarction ~ (1-3), the immediate use of AMI The treatment programs, such as oxygen, analgesics, β-blockers, nitroglycerin Oil and other treatment, the symptoms quickly eased, disappeared, dynamic observation of ECG changes combined with AMI ECG evolution .Final cured.