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目的:探讨急性右心室心肌梗死的临床特点、心电图特征及治疗特殊性,为提高急性右心室心肌梗死的诊断和治疗水平提供参考依据。方法:收集2006年6月—2011年6月在我院心内科住院治疗的48例急性右心室心肌梗死患者的临床资料,进行整理和分析。结果:48例急性右心室心肌梗死患者经综合治疗后,其中45例急性右心室心肌梗死患者治愈出院,占93.75%,3例急性右心室心肌梗死患者死亡。结论:急性右心室心肌梗死有其独有的临床特点,在治疗上,应给予卧床休息、吸氧重症监护、心电监护、硝酸甘油、阿司匹林抗血小板聚集及华法林抗凝等常规治疗,而对于引起的右心衰竭伴发低血压,宜扩张血容量,待血压回升、血动力学稳定后,尽早小剂量应用硝酸甘油及多巴酚丁胺,这对左室功能的改善也非常有益。
Objective: To investigate the clinical features, electrocardiogram characteristics and treatment specificity of acute right ventricular myocardial infarction, and to provide a reference for improving the diagnosis and treatment of acute right ventricular myocardial infarction. Methods: The clinical data of 48 patients with acute right ventricular myocardial infarction admitted to our hospital from June 2006 to June 2011 were collected and analyzed. Results: Forty-eight patients with acute right ventricular myocardial infarction were treated by combined therapy. Forty-five patients with acute right ventricular myocardial infarction were cured and discharged, accounting for 93.75%. Three patients died of acute right ventricular myocardial infarction. CONCLUSIONS: Acute right ventricular myocardial infarction has its own unique clinical features. In treatment, regular rest should be given in bed rest, intensive care of oxygen, ECG, nitroglycerin, antiplatelet aggregation of aspirin and warfarin anticoagulation. However, Right ventricular failure caused by associated with hypotension, dilatation of blood volume should be until the blood pressure rise, hemodynamic stability, the early application of small doses of nitroglycerin and dobutamine, which is also very beneficial to improve left ventricular function.