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患者,男,60岁。因阵发性心前区压榨性剧痛伴大汗反复发作16小时入院。查体:心音低钝。心电图示急性前壁心肌梗塞。急入院后当天下午14:10患者突然呼吸困难,面色青紫,随及心跳呼吸停止,瞳孔散大,血压0。立即进行胸外按压,气管插管,心内注射肾上腺素,异丙基肾上腺素各1mg,静推洛贝林3mg,心电示波为室颤。用300瓦秒非同步电击除颤,除颤后示波为室颤,短暂室速。病人开始有6～7次/分缓慢自主呼吸。继续胸外按压,再次静推肾上腺素1mg,利多卡因50mg。14:30分示波为粗大室颤,继之又用350瓦秒二次电除颤,本次除颤后病人自主呼吸恢复至16次/分,血压10/7kPa,心跳恢复,心音低钝,心率62次/分,律不齐,可闻及阵发性心动过速。心电图示为交界
Patient, male, 60 years old. Paroxysmal paroxysmal acute exacerbation of pain accompanied by repeated attacks of 16 hours admission. Examination: heart sound low blunt. ECG shows acute anterior myocardial infarction. Emergency 14:10 on the day after admission, the patient suddenly breathing difficulties, looking bruising, with and breathing stopped, mydriasis, blood pressure 0. Immediate chest compression, endotracheal intubation, intracardiac injection of epinephrine, isopropyl epinephrine 1mg, intravenous Lobelin 3mg, ECG as ventricular fibrillation. Treated with 300-watt non-synchronous shock defibrillation, post-defibrillation as ventricular fibrillation, short-term VT. The patient started 6 to 7 times / min spontaneous breathing slowly. Continue chest compressions, once again static push adrenaline 1mg, lidocaine 50mg. 14:30 minutes for the large ventricular fibrillation shock, followed by another 350 watts second defibrillation, the patient defibrillation spontaneous breathing recovery to 16 beats / min, blood pressure 10 / 7kPa, heart rate recovery, low heart sound blunt , Heart rate 62 beats / min, irregularities, can be heard and paroxysmal tachycardia. ECG shown as the junction