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急性心肌梗塞栓塞性并发症以脑栓塞和肺栓塞最为常见,其次是四肢动脉栓塞,肠坏死比较少见,我们遇到1例,分析讨论如下:1 临床资料患者男性,44岁,病案号:34298.因持续性胸骨后疼痛4小时急诊入院.体格检查:血压16/10KPa,神志清楚,痛苦病容,卧位,双肺呼吸音清,心律齐,心率90次/分,心尖部第一心音减弱,未闻及杂音,腹软,无压痛,双下肢无浮肿.实验室检查:血沉2mm/h谷草转氧酶12单位.心电图:窦性心律,急性前壁及高壁心肌梗塞.诊断为急性心肌梗塞.给予吸氧,大剂量尿激酶静滴等治疗措施后,症状消失,心电图S—T段比入院时下降3mm,(入院时S—T段抬高5mm).
Acute myocardial infarction embolic complications of cerebral embolism and pulmonary embolism is the most common, followed by extremity arterial embolism, intestinal necrosis is relatively rare, we encountered 1 case, the analysis is as follows: 1 Clinical data Male patients, 44 years old, case number: 34298 Due to persistent chest pain 4 hours emergency admission. Physical examination: blood pressure 16 / 10KPa, conscious, painful illness, supine, lung breath sounds clear, heart rate Qi, heart rate 90 beats / min, first apex heart sounds Weak, no smell and noise, abdominal soft, no tenderness, no swelling of both lower extremities Laboratory tests: ESR 2mm / h aspartate oxygenase 12 units Electrocardiogram: sinus rhythm, acute anterior wall and high wall myocardial infarction Diagnosis of Acute myocardial infarction. After the treatment of oxygen inhalation, high-dose intravenous infusion of urokinase and other treatment measures, the symptoms disappeared. The S-T electrocardiogram decreased by 3mm compared with that at admission (5mm higher at S-T admission).