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1、临床资料 患者男,48岁。因突发心前区剧痛,并放射至背部,有压榨恐惧感,恶心呕吐两次,于1998年6月17日凌晨2点30分急诊来我部。病前4h有饮酒史。体检:血压11/8Kpa,脉搏80次/min,呼吸40次/min。急性痛苦病容。高声呻吟,皮肤苍白潮湿,四肢凉,神志清,心界不大,心音低钝。心率80次/min,律不齐,可闻及期前收缩6—8次/min,各瓣膜听诊区未闻及杂音,双肺呼吸音正常。心电图示:广泛前壁,侧壁超极化期改变,T波高尖宽大,有钝挫。初诊:急性广泛前壁MI伴心律失常,心源性休克。门诊即给予:①高流量吸氧;
1, clinical data Male patient, 48 years old. Due to the sudden onset of acute precordial pain and radiation to the back, there is fear of crushing and nausea and vomiting twice. At 2:30 on June 17, 1998, I came to the Ministry of Emergency. 4h before drinking history. Physical examination: blood pressure 11 / 8Kpa, pulse 80 beats / min, breathing 40 beats / min. Acute pain and sickness. Moaning, pale skin wet, cold limbs, clear-minded, little heart, low heart sound blunt. Heart rate 80 beats / min, irregular, can be heard and premature contraction 6-8 times / min, the valve auscultation area did not smell and noise, lungs breath sounds normal. ECG shows: extensive anterior wall, hyperpolarisation of the wall changes, T wave high tip wide, blunt. New diagnosis: Acute extensive anterior MI with arrhythmia, cardiogenic shock. Outpatient is given: ① high-flow oxygen;