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本文报告2例青年于胸部钝性外伤后出现心肌异常Q波和损伤性ST段抬高,其心电图和心肌酶学的演变与典型的急性心肌梗塞(AMI)相同。胸部钝性外伤致AMI的主要机理为冠状动脉内膜扯裂、内膜下出血、血栓形成以及粥样斑块扯裂而导致冠状动脉阻塞,受累最多的是左前降支。由于常伴体表、心脏或其它脏器的挫伤或损伤,全身抗凝或静脉溶栓治疗通常为禁忌。如病人条件允许,可施行冠脉搭桥、PTCA或冠状动脉内溶栓等治疗。
This article reports two cases of young patients with chest wave blunt trauma after the occurrence of abnormal Q-wave myocardial damage and ST-segment elevation, ECG and myocardial enzymatic evolution and typical acute myocardial infarction (AMI) the same. The main mechanism of AMI caused by blunt traumatic injury is coronary artery occlusion caused by coronary intimal tear, subendothelial hemorrhage, thrombosis and atherosclerotic plaque. The most common cause of AMI is left anterior descending artery. Generalized anticoagulation or intravenous thrombolysis is often contraindicated due to contusion or injury often associated with body surface, heart, or other organs. If the patient conditions permit, coronary bypass surgery, PTCA or coronary thrombolysis and other treatment.