论文部分内容阅读
患者,男,53岁。因突发性心前区压榨性疼痛6h,于1987年7月5日入院。体检:体温36.4℃,脉搏70次,血压14.6/9.3kPa(110/70mmHg 1mmHg=0.133kPa)。神志清,两肺呼吸音清,心界正常,心率86次,频发早搏。心电图示Ⅱ、Ⅲ、aVF,V_2～V_6ST弓背向上抬高0.2～0.9mV,V_1～V_4为QR波,QRS时间0.14s,V_1、aVR的R波及Ⅱ、Ⅲ、aVF,V_6的S波宽钝,频发多源性室性早搏。血清心肌酶升高,24h查GOT420U/L,CPK1627U/L,LDH470U/L,肌红蛋白480ng/ml。诊断:急性广泛前壁心肌梗塞,颊发多源性室性早搏,完全性右束支阻滞。发病24h出现心前区锐痛及心包摩擦音,心电图出现左前分支阻滞。应用Swan-Gans导管在床旁行血液动力学监测,测得中心静脉压1.20kPa,肺动脉压3.33/1.60(2.53)kPa,肺毛细血管楔压2.53kPa,血压13.3/9.9kPa。经在心
Patient, male, 53 years old. Due to sudden preeclampsia pain 6h, on July 5, 1987 admitted. Physical examination: body temperature 36.4 ℃, pulse 70 times, blood pressure 14.6 / 9.3kPa (110 / 70mmHg 1mmHg = 0.133kPa). Consciousness, breath sounds clear lungs, heart normal, heart rate 86 times, frequent premature beats. The electrocardiogram showed that the wave amplitude of Ⅱ, Ⅲ, aVF and V_2 ~ V_6ST was 0.2 ~ 0.9mV, V_1 ~ V_4 was QR wave, QRS time was 0.14s, V_1, aVR and S wave width of Ⅱ, Ⅲ, aVF and V_6 Blunt, frequent multi-ventricular premature beats. Serum myocardial enzymes increased, 24h check GOT420U / L, CPK1627U / L, LDH470U / L, myoglobin 480ng / ml. Diagnosis: Acute extensive anterior myocardial infarction, buccal multi-ventricular premature beats, complete right bundle branch block. Emergence of acute heart palpitation and pericardial rachis occurred 24h, electrocardiogram left front branch block. Swan-Gans catheter at the bedside hemodynamic monitoring, measured central venous pressure 1.20kPa, pulmonary artery pressure 3.33 / 1.60 (2.53) kPa, pulmonary capillary wedge pressure 2.53kPa, blood pressure 13.3 / 9.9kPa. After heart