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病史摘要:男性患者,70岁,因两个月前无明显诱因开始出现右上腹疼痛不适,无放射状痛,不伴恶心、呕吐、发热、寒战、黄疸、无尿频、尿急、尿痛。经上级医院确诊为肝癌。发病后患者食欲不佳,入院前突发心慌、神智恍惚、尿量少(陪护家属诉)。急查心电图:各导联P波显示不清、P-R及Q-T间期各波形分界不清,无法精确测定,II、III、AVF、V1~V6呈r S型、S波明显增宽、各导联QRS与ST-T之间分界不清,既不像右束支传导阻滞又不像左束支传导阻滞,QRS波时限延长、T波振幅低且圆钝,呈窦室传导(如图1)。入院后查血钾7.60mmol/L,经过对症支持治疗后复查心电图无改变,血钾7.96mmol/L呈上升趋势,请肾内科会诊行血液透析后,患者临床症状缓解,再次复查心电图显示正常(如图2)。
Medical history Abstract: A male patient, aged 70, developed right upper quadrant pain discomfort, no radiating pain, no nausea, vomiting, fever, chills, jaundice, frequent urination, urinary urgency, and dysuria due to no obvious predisposition for two months. The higher level of hospital diagnosed with liver cancer. After the onset of poor appetite in patients with sudden onset of panic before, mentally trance, less urine (accompanying family members v.). Urgent ECG: ECG P wave of each lead is unclear, PR and QT interval waveform clear boundaries, can not be accurately measured, II, III, AVF, V1 ~ V6 was r S-type, S wave significantly widened, each guide Link between the QRS and ST-T unclear boundaries, neither right bundle branch block nor left bundle branch block, QRS wave duration extension, T wave amplitude is low and blunt, was sinus conduction (such as figure 1). Check admission potassium 7.60mmol / L, after symptomatic supportive treatment review electrocardiogram no change, serum potassium 7.96mmol / L showed an upward trend, please referral renal hemodialysis patients, clinical symptoms, re-examination of ECG showed normal Figure 2).