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目的探讨不典型急性心肌梗死的临床特点及诊治措施。方法回顾分析120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97例,死亡23例,其中死于心源性休克12例,心律失常7例,心力衰竭4例。结论对急性心肌梗死疼痛部位变异和首发症状变异要有足够认识,避免诊断思维的局限性和鉴别诊断的片面性。对于不典型的心电图表现要注意识别,追踪复查,严密监测,减少AMI的漏诊或误诊。
Objective To investigate the clinical features and diagnosis and treatment of atypical acute myocardial infarction. Methods The clinical data of 120 patients were retrospectively analyzed. The results of a clear diagnosis of bed rest, oxygen, ECG monitoring, dilatation of coronary arteries, cardiac nutrition, anti-platelet aggregation, anticoagulation, thrombolysis and other comprehensive treatment, 97 cases of remission, 23 died, of which died of cardiogenic 12 cases of shock, 7 cases of cardiac arrhythmia, 4 cases of heart failure. Conclusion Acute myocardial infarction in the pain site variation and the first symptom variation should have enough understanding to avoid the limitations of diagnostic thinking and differential diagnosis of one-sidedness. For atypical ECG performance should pay attention to identify, follow-up review, close monitoring, to reduce the missed diagnosis or misdiagnosis of AMI.