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自1970年 Swan-Ganz 导管临床应用以来,对右室梗塞的诊断和治疗已引起临床重视,但在术中出现右室梗塞国内外尚少报道。我院在术中曾遇一例现报告如下。患者女性,70岁。因左股骨下段骨折入院。既往有高血压、冠心病史。入院后描记心电图显示:窦性心率:心电轴+75°;频发室性早搏。1989年10月10日8时30分在连续硬膜外麻醉下行钢板内固定术。麻醉前血压28.0/14.7kPa。术中血压进行性下降,虽经输血、补液和应用升压药物等,但血压仅维持在8.0-9.33/5.33kPa。颈静脉怒张,但呼吸音清晰。12时手术结束。12时10分心脏停跳,经急救复跳唇心电图显示(见附图上行):窦性心律;心电轴右移至+105°;QRS 时间增宽至0.13秒,V_1变为 qR 型,R
Since the clinical application of Swan-Ganz catheter in 1970, the diagnosis and treatment of right ventricular infarction have caused clinical attention, but there are few reports of right ventricular infarction in our country at home and abroad. Our hospital has encountered a case during surgery are as follows now report. Patient female, 70 years old. Left femur fracture due to left hospitalization. Past history of hypertension, coronary heart disease. Post-hospital electrocardiogram tracing showed: sinus heart rate: ECG axis + 75 °; frequent premature ventricular contractions. At 10:30 on October 10, 1989 under continuous epidural anesthesia plate internal fixation. Blood pressure before anesthesia 28.0 / 14.7kPa. Intraoperative blood pressure decreased, although the blood transfusion, rehydration and the use of antihypertensive drugs, but only maintained at 8.0-9.33 / 5.33kPa blood pressure. Jugular vein distention, but the breath sounds clear. 12 when surgery is over. 12: 10 cardiac arrest, flashback the first aid ECG (see the photo line): sinus rhythm; ECG axis shifted to +105 °; QRS time widened to 0.13 seconds, V_1 into qR type, R