论文部分内容阅读
冠心病并心室纤颤(简称室颤,下同)电击3次抢救成功,笔者见到2例,结合文献报告如下。病例报告例1,男,41岁。以心前区闷痛6小时急诊入院。既往无冠心病史。急查ECG:II、III、aVF及V_1、V_(3R)、V_(4R)、VE均呈QS波,ST段弓背向上抬高与T波融合形成单向曲线。诊断:急性下壁及右室心肌梗塞。即直送心导管室,在局麻下行经皮冠状动脉内溶栓术(PTCR)。术中冠状动脉造影发现右冠状动脉主干距开口3cm处呈杵状闭塞,左冠状动脉正常。即经导管向右冠状动脉内连续缓注尿激酶,当累积达66万u时,突然心电监护显示室颤,数秒后出现抽搐,意识丧失,即以300焦耳非同步体外电击除颤,ECG示:窦性心动过速、频发多源室早、短阵室速,2分钟后又接连
Coronary heart disease and ventricular fibrillation (referred to as ventricular fibrillation, the same below) three times the successful rescue, I saw two cases, combined with the literature as follows. Case report 1, male, 41 years old. Premarital area boring pain 6 hours emergency admission. No previous history of coronary heart disease. ECG: II, III, aVF and V_1, V_ (3R), V_ (4R), VE were QS wave, ST segment dorsal raise and T wave fusion to form a one-way curve. Diagnosis: acute inferior wall and right ventricular myocardial infarction. That is, direct delivery of cardiac catheterization room, under local anesthesia percutaneous coronary thrombolysis (PTCR). Intraoperative coronary angiography found that the right coronary artery 3cm at the opening of the mouth was clubbing occlusion, left coronary artery normal. Namely, continuous catheterization of urokinase through the catheter to the right coronary artery. Sudden ECG monitoring showed ventricular fibrillation when accumulated to 660,000 u. After several seconds, convulsions and loss of consciousness were achieved, ie, 300 joules of unscheduled extracorporeal shock defibrillation and ECG Show: Sinus tachycardia, frequent multi-source room early and short-term VT, 2 minutes after another