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目的探讨急性右室心肌梗死(acute right ventricular myocardal infarction,ARMI)的临床表现、心电图特征及其治疗的特殊性。方法回顾性分析79例ARMI患者的临床表现及诊疗经过。结果 ARMI多合并下壁后壁梗死(96.7%),单纯右室梗死发生率低(2.5%),除溶栓等治疗外要维持其特殊的血流动力学稳定。结论急性下壁后壁心肌梗死应常规加做右胸导联以防右室梗死的漏诊,ARMI的治疗关键为扩容及血流动力学稳定后尽早应用多巴酚丁胺和硝酸甘油。
Objective To investigate the clinical manifestations, electrocardiographic features and the special treatment of acute right ventricular myocardium infarction (ARMI). Methods A retrospective analysis of 79 cases of ARMI patients with clinical manifestations and treatment after. Results ARMI combined multiple posterior wall infarction (96.7%), simple right ventricular infarction (2.5%), in addition to thrombolytic therapy to maintain its special hemodynamic stability. Conclusions Acute inferior posterior wall myocardial infarction should be routinely done with right chest lead to avoid misdiagnosis of right ventricular infarction. The key to ARMI treatment is to use dobutamine and nitroglycerin as soon as possible after dilatation and hemodynamic stability.