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患者,女,56岁。因突发心悸伴胸翳闷、头晕、气促、出汗3小时,自服消心痛等药无效前来我科急诊。有“预激综合征”病史,4个月前曾患急性前间壁心肌梗塞。查体:神清、焦虑、皮肤湿暖、呼吸尚平顺,口唇指甲无发绀,双肺未闻及干湿性罗音,心律整,HR180BPm,BP11/6kPa,床旁ECG证实室上性心动过速。 进入观察室后即给氧,开放静脉通道、接心电示波监测,随即给患者及其家属介绍心前区拳击转律的目的和做法,征得患者及其家属同意配合后即唤患者平卧位,以左手掌心紧贴病人心尖搏动最明显处,右手握拳以尺侧用中等强度的力量突然拳击左手背部,终于一次拳击复律成功,心电示波显示窦性心律,HR67BPm,患者也随着突然的惊跳后,心悸、胸翳闷消
Patient, female, 56 years old. Due to sudden heart palpitations with chest tightness, dizziness, shortness of breath, sweating 3 hours, self-serving heartburn and other drugs invalid to our department emergency. A “pre-excitation syndrome” history, 4 months ago had acute anterior myocardial infarction. Physical examination: Shen Qing, anxiety, wet skin, breathing is smooth, no cyanosis of lips and nails, lungs unhealthy and wet and dry rales, rhythm, HR180BPm, BP11 / 6kPa, bedside ECG confirmed supraventricular tachycardia speed. After entering the observation room that is, oxygen, open venous access, then ECG wave monitoring, and then to patients and their families about the purpose and practice of precocious boxing turnaround, patients and their families agreed to call the patient Ping Supine position to the left palm close to the patient’s apical beat the most obvious place, right hand fist to the ulnar side with a moderate strength suddenly boxing left hand back, finally a boxing cardioversion success, ECG showed sinus rhythm, HR67BPm, patients also With a sudden startled, heart palpitations, chest boredom disappear