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目的 探讨严重急性呼吸综合征 (SARS)患者心脏骤停的原因。方法 对 15例SARS心脏骤停病例的流行病学、临床表现、实验室检查、影像学检查及治疗措施 ,进行回顾性分析。结果15例SARS心脏骤停病例 ,平均年龄 60岁 ;8例有明确的SARS患者接触史 ,其中 6例属于家庭内密切接触发病 ;8例无基础疾病 ;8例精神异常紧张 ;9例心脏骤停于病情稳定时 ;4例于排便后心脏骤停 ;10例患者心肌酶异常 ;13例双侧肺部有斑片状阴影 ;5例心脏骤停前有心肌缺血及心律失常的心电图表现。结论 SARS患者心脏骤停的原因可能为 :( 1)SARS病毒损伤肺组织引起机体缺氧 ,导致心电不稳定。 ( 2 )SARS病毒直接损伤心肌细胞和 (或 )心脏传导系统。 ( 3 )SARS病毒感染加重原有心肌病变及传导障碍。 ( 4 )精神异常紧张 ,儿茶酚胺过度释放 ,导致心电不稳定。 ( 5)排便加重缺氧 ,诱发心律失常 (心室颤动等 )而导致心脏骤停
Objective To investigate the causes of cardiac arrest in patients with severe acute respiratory syndrome (SARS). Methods The epidemiological, clinical manifestations, laboratory tests, imaging examination and treatment of 15 cases of SARS were retrospectively analyzed. Results Fifteen patients with SARS had a mean of 60 years of age. Eight patients had a clear history of exposure to SARS. Six patients were closely contacted within the family, eight had no underlying disease, eight were abnormally nervous, nine had cardiac arrest Stopped in stable condition; 4 cases of cardiac arrest after defecation; 10 cases of myocardial enzyme abnormalities; 13 cases of bilateral lung patchy shadows; 5 cases of cardiac arrest before myocardial ischemia and arrhythmia ECG performance . Conclusion The causes of cardiac arrest in patients with SARS may be: (1) SARS virus causes lung tissue damage caused by hypoxia, leading to unstable ECG. (2) SARS virus directly damages cardiomyocytes and / or cardiac conduction system. (3) SARS virus infection aggravates the original cardiomyopathy and conduction disorders. (4) the spirit of abnormal tension, excessive release of catecholamines, leading to unstable ECG. (5) defecation increased hypoxia, induced arrhythmia (ventricular fibrillation, etc.) and lead to cardiac arrest