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病史摘要患者张××,女,60岁.反复出现浮肿,尿少十余年,三天来加重,于1983年7月4日住院。体检:嗜睡,贫血貌。心界不大,未闻及病理性杂音,律齐,心率92～93次/分。两肺满布干、湿罗音。下肢凹陷性浮肿,实验室检查,血尿素氮64.5mg％,二氧化碳结合力26.7vol％,血清钾3.7mEq/L,临床诊断:慢性肾炎,尿毒症,肺部感染。入院后感染未能控制,肾功能继续衰竭。11月7日血压降到90/60,神志昏迷,抢救无效死亡。住院期间反复出现各种心律失常,分析如下: 心电图分析图1(V_1 导联),呈每分187次的房性心动过速,伴2∶1房室传导阻滞。第11、12连续2个P′波未能下传;可能为P(11)′呈隐匿传导,穿透房室结的较深
Medical history Abstract Zhang × ×, female, aged 60. Repeated edema, less urine more than ten years, three days to aggravate, in July 4, 1983 hospitalization. Physical examination: lethargy, anemia appearance. Heart, not heard and pathological murmur, law Qi, heart rate 92 ~ 93 beats / min. Two lungs covered with dry rales. Lower limb pitting edema, laboratory tests, blood urea nitrogen 64.5mg%, carbon dioxide binding 26.7vol%, serum potassium 3.7mEq / L, clinical diagnosis: chronic nephritis, uremia, lung infection. Infected after admission failed to control the renal failure continue to function. November 7 blood pressure dropped to 90/60, unconscious, rescue dead. Repeated arrhythmia during hospitalization, the analysis is as follows: ECG analysis Figure 1 (V_1 lead), was 187 points per atrial tachycardia, with 2: 1 atrioventricular block. The 11th and 12th consecutive two P ’waves failed to be transmitted. P (11)’ could be hidden conduction and penetrate the deeper atrioventricular node