论文部分内容阅读
患者男,65岁。因持续性胸骨后疼痛3小时入院。呈持续性剧痛,伴有大汗及压迫感,疼痛可扩散至左上肢,经安静休息和含用硝酸甘油不能使胸痛消先。既往史:糖尿病史10余年,冠心病史6余年。查体:体温36.2℃,脉搏98次/分,血压10/6kPa(75/45mmHg),发育正常,意识清晰,半卧位,面色苍白,唇绀,颈静脉怒张,双肺底闻及少量湿性罗音,胸骨左缘第3、4肋间触及收缩期震颤,心界向两侧扩大,心率98次/分,心音钝,律齐,胸骨左缘第3、4肋间可闻及收缩期杂音,强度Ⅴ级。肝肋下可及2.0cm,脾未及。四肢无畸形,双下肢轻度水肿。实验室检查肝肾功能无异常。X线心脏三位片显示:左室
Male patient, 65 years old. 3 hours after persistent chest pain due to hospitalization. Was persistent pain, accompanied by sweating and oppression, pain can spread to the left upper limb, resting quietly and containing nitroglycerin can not make chest pain first. Past history: history of diabetes more than 10 years, history of coronary heart disease more than 6 years. Examination: body temperature 36.2 ℃, pulse 98 beats / min, blood pressure 10 / 6kPa (75 / 45mmHg), normal development, clear consciousness, semi-recumbent, pale, cyanosis, jugular vein engorgement, Humoral rales, sternal border 3,4 on the left edge of the interictal systolic tremor hit the heart bound to both sides of the enlarged heart rate 98 beats / min, heart sound blunt, law Qi, sternal left and right 3,4 intercostal can smell and shrink Period murmur, intensity Ⅴ level. Under the ribs can reach 2.0cm, spleen and time. No limb deformities, mild lower extremity edema. Laboratory examination of liver and kidney function without exception. X-ray three-slice showed: left ventricular