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急性心肌梗塞是冠心病中最严重的一种类型。如同时发生心脏骤停,死亡率尤高。笔者于1979年1月10日抢救一例急性广泛前壁心肌梗塞、心脏骤停获得成功,现报告如下:病例介绍马某,男,54岁,农民。上午8时在田间劳动时,突感上腹部及心前区闷痛,继而呼吸困难、冷汗、恶心、呕吐多次,10时急诊来院。查心电图示:胸前导联 V_1至 V_5ST 段呈不同程度弓背向上抬高,T 波倒置,V_1至 V_3心室波呈 QS 型,Ⅰ、avI 导联亦出现异常 Q 波,对应导联Ⅱ、Ⅲ、aVF出现相反变化(ST 段下移,T 波增高)。心电图诊断:急性广泛前壁心肌梗塞。上午11时30分入院。患者神清,表情痛苦。体温38.4℃,呼吸36次/分,心率118次/分,血压94/56mmHg.心脏听诊第一心音减弱,两肺(一),肝脾未触及。舌下含化硝酸甘油0.6毫克而胸痛未缓解。下午3时肌注杜冷丁50毫克后胸痛减轻。
Acute myocardial infarction is the most serious type of coronary heart disease. If cardiac arrest occurs at the same time, the death rate is particularly high. The author on January 10, 1979 to rescue a case of acute extensive anterior myocardial infarction, cardiac arrest was successful, are as follows: Case introduction Mamou, male, 54 years old, farmer. 8 o’clock in the field when working, suddenly felt the upper abdomen and precordial boring pain, then breathing difficulties, cold sweat, nausea, vomiting many times, 10 o’clock emergency hospital. Check electrocardiogram: chest lead V_1 to V_5ST segment showed varying degrees of arch dorsal elevation, T wave inversion, V_1 to V_3 ventricular wave was QS type, Ⅰ, avI lead also appeared abnormal Q wave, corresponding to the lead Ⅱ, Ⅲ, aVF opposite changes (ST segment down, T wave increased). ECG diagnosis: Acute extensive anterior myocardial infarction. 11:30 admission. Clear patient expression of pain. Body temperature 38.4 ℃, breathing 36 beats / min, heart rate 118 beats / min, blood pressure 94/56 mmHg. Heart auscultation first heart sound weakened, both lungs (a), liver and spleen not touched. Sublingual nitroglycerin 0.6 mg and chest pain did not ease. At 3 pm after intramuscular injection of pethidine 50 milligrams relieve chest pain.