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患者男性,26岁。因反复发作性胸闷、心悸、乏力5年,再发3天于1688年2月7日来本院急诊后转入监护病房。患者曾于1983年2月、1986年3月2次诊断“病毒性心肌炎”住本院,经用乙胺碘呋酮、安搏律定等抗心律失常药物治疗后早搏消失出院,能胜任重体力劳动。本次发作在急诊室测BP100/90mmHg,心率180次/min,心律不甚规则,心电图示:室性心动过速(附图A)心室率167—150次/min,伴心室夺获,室性融合波,房室分离,电轴显著左偏-80°,宽大畸形的QRS波群呈束支阻滞型。在急诊室治疗5h,先后静脉注射利多卡因530mg,溴苄胺250mg,未见效果,室速持续存在。改用维拉帕米5mg+50%GS20ml静脉缓慢注射,当注入3mg时,室速终止转窦性节律,送入监护病房。体检:T37℃,P100次/min,R20次/min,BP116/68mmHg,神志清,唇无发绀,颈静脉无怒张,心界不大,心率100次
Male patient, 26 years old. Due to recurrent chest tightness, palpitations, fatigue 5 years, 3 days after the recurrence of February 7, 1688 to hospital emergency room after intensive care unit. Patients in February 1983, March 1986 2 times diagnosed “viral myocarditis” to live in our hospital, with amiodarone, ambroxidine and other antiarrhythmic drugs after discharge disappeared premature beats, capable of weight Manual labor. The attack in the emergency room measured BP100 / 90mmHg, heart rate 180 beats / min, irregular heart rate, ECG: ventricular tachycardia (Figure A) ventricular rate 167-150 beats / min, with ventricular seizures, room Sexual fusion wave, atrioventricular separation, electrical axis was significantly left -80 °, broad deformity of QRS complex beam bundle block type. Treatment in the emergency room 5h, intravenous injection of lidocaine 530mg, bromobenzyl amine 250mg, no effect, continuous presence of ventricular tachycardia. Use verapamil 5mg + 50% GS20ml slow intravenous injection, when the injection of 3mg, VT termination of sinus rhythm, into the intensive care unit. Physical examination: T37 ℃, P100 times / min, R20 times / min, BP116 / 68mmHg, clear mind, lip cyanosis, no jugular vein engorgement, heart, heart rate 100