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目的探讨不典型急性心肌梗死的临床诊治措施。方法分析本院收治的81例患者的临床资料。结果明确诊断后给予卧床休息、吸氧、心电监护、扩张冠状动脉、营养心肌、抗血小板聚集、抗凝、溶栓等综合治疗,病情缓解68例,死亡13例,其中死于心源性休克7例,心律失常4例,心力衰竭2例。结论对原因不明的急性腹痛,尤其是既往有冠心病及其易患因素者,应警惕急性心肌梗死的可能性,注意观察有无胸闷、胸痛及其血压变化情况,结合临床体征及心电图进行综合分析,必要时行心肌酶谱检查并动态观察以避免误诊。
Objective To investigate the clinical diagnosis and treatment of atypical acute myocardial infarction. Methods The clinical data of 81 patients admitted to our hospital were analyzed. The results of a clear diagnosis of bed rest, oxygen, ECG monitoring, dilatation of coronary artery, myocardial nutrition, anti-platelet aggregation, anticoagulation, thrombolysis and other comprehensive treatment, 68 cases of remission, 13 deaths, of which died of cardiogenic 7 cases of shock, 4 cases of arrhythmia, 2 cases of heart failure. Conclusion For acute unexplained abdominal pain, especially those with previous coronary heart disease and its predisposing factors, we should be alert to the possibility of acute myocardial infarction, observe the presence or absence of chest tightness, chest pain and blood pressure changes, combined with clinical signs and ECG synthesis Analysis, if necessary, myocardial enzymes and dynamic observation to avoid misdiagnosis.