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患者男,65岁。因进行性吞咽困难2个月而行胃镜检查,否认既往有高血压及冠心病史。术前用1%地卡因作咽喉部喷雾局麻2次。数分钟后患者取左侧卧位,Olympus-Q_(10)型胃镜插入,顺利通过咽喉部、食道,抵贲门口见粘膜广泛糜烂,表面附污秽苔,蠕动扩张明显受限。继续进镜,直抵球部。未发现球部及胃部病变。退镜至贲门口,见贲门口糜烂性病灶,且有新鲜渗血,送水冲去血迹,完成第一块活检。此时病人突然恶心,烦躁,右手握拳叩敲胸口,脸色顿时苍白。测脉搏、心率为58次/分,心律明显不齐。立即退镜,作ECG提示频发室性早搏,呈二联律及三联律。取平卧位,数分钟后,病人上
Male patient, 65 years old. Due to progressive dysphagia for 2 months underwent gastroscopy, denied the previous history of hypertension and coronary heart disease. Preoperative 1% dexamethasone throat spray local anesthesia 2 times. A few minutes later, the patient took the left lateral position. The Olympus-Q_ (10) gastroscope was inserted through the larynx, esophagus and cardia to see the mucosa extensive erosion. The surface was contaminated with fouling moss and the peristalsis was obviously limited. Continue to enter the mirror, straight to the ball. Did not find the ball and stomach lesions. Exit to the cardia, see the cardia erosive lesions, and fresh oozing, water rushed to the blood to complete the first biopsy. At this point the patient suddenly nausea, irritability, right hand knock knock knock knock chest, his face suddenly pale. Measured pulse, heart rate 58 beats / min, obviously irregular heart rhythm. Immediately back to the mirror, ECG prompts for ventricular premature beats, was two law and triple law. Take the supine position, a few minutes later, the patient