急性心梗合并复合发症 Microsoft Word 文档.doc

急性心肌梗塞并发复合性并发症PCI成功1例 关键词：急性心肌梗塞 并发症 PCI（经皮冠状动脉介入治疗） 典型病例 患者，男，68岁，当地农民。2013年2月19日因突发胸骨后压痛2小时入院，入院时一般情况尚可，生命体征稳定，心电图Ⅱ、Ⅲ、avF导联ST段抬高明显，心肌酶明显增高（CK3219U、CKMB543U），血尿常规正常，血小板263×109 /L。诊断：冠心病 急性下壁心肌梗塞。立即按急性心梗处理，给吸氧、建立静脉通道、卧床休息，静脉注入普通肝素5000U。经动员，家属及病人同意接受急诊PCI治疗，按常规给术前准备及口服负荷量氯吡格雷600mg,阿斯匹林300 mg。冠脉造影发现左主干狭窄40%，前降支、回旋支均有弥漫性中度狭窄、纡曲和硬化，但血流尚好。右冠近段闭塞。造影中病人出现心动过缓，心率40次/分左右，血压下降至60mmHg，并出现躁动、恶心、呕吐，呼吸变浅慢、暂停，神志模糊，透视显示心跳无力。立即按迷走神经返射处理，立即给胸外挤压、人工呼吸、加大吸氧、静注阿托品、多巴胺、肾上腺素后血压回升、心率加快，出现窦性心动过速，交替间断出现室速室颤，先后给电复律和电除颤4次有效，静注胺碘酮等，但仍有短暂室速反复发作，考虑有交感风暴，加用艾斯洛尔30mg静量0.05mg/kg/min），王晓玲佘红参附注射液拮抗多巴胺依赖32例观察侯丽芳,盘强文.??缺血预处理在再灌注心律失常中的应用及研究进展[J]. 医学综述. 2010(13) conferences, learned superiors policies; reports, you can learn to deal with problems, art, just wanted to learn, to learn at any time. To continuously expand the scope of the study. The complexity and comprehensiveness of our work, decided to not only do we want to be professionals, or if generalists, to dabble in different areas of knowledge. Mastery of knowledge not only to have knowledge to rational analysis. This on requirements we, not only to learning national of route, and approach, and policy, also to learning national of legal, and regulations; not only to with political theory armed mind, also to with economic theory guide work; not only to read history, also to read history; not only to absorption SM of mirror, also to gets is of road; not only to from local learn, also to to outside learn; not only to to books learn, also to field study learn. 　　Therefore, I would encourage you, and more to the outside world when I have time to take a look at, take a stroll, outside developments, learn other peoples development approach, and then come back to guide our work. Second, we must think. Learning without thought to overshadow, thinking without learning is perilous. We want to foster the character of advancing with the times, forge ahead, often reflect themselves in adapting to the new situation on whether there are delays, have