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急性心肌梗塞并发室性心动过速,病情严重,极易转为室颤,死亡率高。对于一些经药物治疗无效的患者,使用临时起搏治疗是一个行之有效的方法。笔者曾用此法控制1例急性下壁心肌梗塞并发顽固性室速1例,报告如下. 患者 女性,57岁。因胸闷气急不能平卧10天,1986年4月21日入院。体检:半卧位.呼吸稍急促,无紫绀;心率98次/分,律齐,心前区Ⅱ级收缩期杂音,双肺底部可闻细湿罗音;心电图示陈旧性前壁心肌梗塞,肝肾功能、血糖、血脂均正常,经治疗1周后病情好转。4月30日上午突发心悸、头昏。体检:BP80/50mmHg,P186次/分,心电示波为室性心动过速.即用利多卡因100mg先后3次静注无效,改用普鲁卡因酰胺400mg静注、室速仍未得到控制,后经直流电击150ws转为窦性.常规心
Acute myocardial infarction complicated by ventricular tachycardia, a serious condition, easily converted to ventricular fibrillation, high mortality. For some patients who are ineffective with medication, the use of temporary pacing therapy is an effective method. I have used this method to control 1 case of acute inferior myocardial infarction complicated by ventricular tachycardia in 1 case, the report is as follows.Female female, 57 years old. Chest tightness due to shortness of breath can not lie 10 days, April 21, 1986 admission. Physical examination: semi-recumbent breathing a little urgency, no cyanosis; heart rate 98 beats / min, law Qi, precordial Ⅱ systolic murmur, the lungs can smell fine wet rales; ECG shows the old anterior myocardial infarction, Liver and kidney function, blood glucose, blood lipids are normal, after 1 week of treatment, his condition improved. April 30 morning sudden heart palpitations, dizziness. Physical examination: BP80 / 50mmHg, P186 beats / min, ECG wave of ventricular tachycardia. Lidocaine 100mg three times with intravenous ineffective use of procaine 400mg intravenously, ventricular rate has not yet Get control, go through the DC shock 150ws into sinus