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病例 男,68岁。近年来曾因阻塞性肺气肿、肺源性心脏病、肺性脑病多次住院治疗。此次因反复咳嗽、气喘、心累、慢性喘息型支气管炎急性发作、急诊入院。附图A为此次入院时常规心电图V_1导联。基本节律为窦性,心率100次/min、P(+-)双向、P—R0.16s。全导联可见二种不同形态的QRS波群,一种为室上型(为V_1导联的基本波型);另一种宽大畸形为右束支型。两种图型时而交替出现,时而为连续性右束支型。附图B为两天后患者临终前抢救之V_1导联,QRS连续宽大畸形之波群,心率:平均168次/min,R—R略有不等,QRS前方似可见P。心电图诊断:图A:窦性心动过速、间歇性完全性右束支传导阻滞、频发性房性期前收缩伴完全性右束支传导阻滞。图B:频发多源性房性期前收缩形成短阵房性心动过速伴完全性右束支传导阻滞。
Male, 68 years old. In recent years, obstructive emphysema, pulmonary heart disease, pulmonary encephalopathy many hospitalized. The repeated cough, asthma, heart tired, acute asthma chronic bronchitis, emergency admission. Figure A for the admission of conventional ECG V_1 lead. The basic rhythm was sinus, heart rate 100 beats / min, P (+ -) bidirectional, P-R 0.16s. There are two types of QRS complexes visible in the whole lead, one is supraventricular (the basic type for V_1 lead), and the other is dextral bundle. The two graphs alternate from time to time, sometimes with a right bundle branch. Figure B for the two days after the patient died before the V_1 lead, QRS continuous large deformity of the wave group, the heart rate: an average of 168 beats / min, R-R slightly different, QRS can be seen in front of P. ECG Diagnosis: Figure A: sinus tachycardia, intermittent complete right bundle branch block, frequent atrial contractions with complete right bundle branch block. Figure B: Frequent, multi-source atrioventricular shortening of the formation of atrial tachycardia with complete right bundle branch block.