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目的探讨急性冠脉综合征(ACS)相关电风暴(ES)的临床特点及治疗方法。方法采用回顾性调查方法,对1例ES致心脏骤停为首发表现的急性心肌梗死患者的临床资料进行分析,并结合文献进行复习。结果患者男,73岁,院内突发意识丧失,心电活动呈顽固性室颤(VF)及室性心动过速(VT),经反复电除颤17次(双相波:200J,11次;300J,4次;360J,2次),联合抗室性心律失常药物,同时应用多项高级生命支持技术,抢救4 h后心肺脑复苏初步成功。结合心肌损伤标志物和心电图动态改变最终诊断急性ST段抬高型广泛前壁心肌梗死,择期行经皮冠状动脉介入治疗(PCI),于前降支和回旋支共植入支架4枚。随访5年,无不良心血管事件发生。结论 ES是临床急危重症,ACS相关ES有其独特的发病特点及救治原则;及时、正确的复苏方案能够提高患者的救治成功率,改善预后。
Objective To investigate the clinical features and treatment of acute coronary syndrome (ACS) related electrical storm (ES). Methods A retrospective study was conducted to analyze the clinical data of 1 acute myocardial infarction (ES) -based cardiac arrest caused by ES and to review the literature. Results The male patient, aged 73, had a sudden loss of consciousness in the hospital and had refractory ventricular fibrillation (VF) and ventricular tachycardia (VT) after repeated defibrillation for 17 times (biphasic wave: 200J, 11 times ; 300J, 4 times; 360J, 2 times), combined with anti-ventricular arrhythmia drugs, while the application of a number of advanced life support technology, 4 h after rescue initial success of CPR. Combined with the dynamic changes of myocardial injury markers and ECG changes in the diagnosis of acute ST-segment elevation anterior wall myocardial infarction, elective percutaneous coronary intervention (PCI), in the anterior descending and circumflex artery scaffolds were implanted a total of four. Follow-up for 5 years, no adverse cardiovascular events. Conclusions ES is a critically ill clinical condition, and ACS-associated ES has its unique characteristics of onset and treatment. A timely and correct recovery plan can improve the success rate and improve the prognosis of patients.