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患者,男,86岁.因反复发作心悸2天入院.既往有阵发性心动过速病史20余年.体检:血压16/10kPa,神志清楚,呼吸平稳,心率160次/分,律齐,无杂音,心界无扩大,四肢无水肿.心电图(附图A)示室上性心动过速(室上速).拟诊:阵发性室上速.入院当晚21时在心电监护下5min内静注心律平60mg+10%葡萄糖注射液20ml时患者诉全身发热,心电监护示窦性心律,心率97次/分,立即停药,维持静脉通路,继续观察,15min后心率逐渐变慢,心电图(附图B)示交界性逸搏.患者诉腹部不适,随即四肢抽搐,意识丧失,心跳停止,心电监护示心室停搏(附图C),立即胸外按压,给氧,静注肾上腺素1mg,2min后出现心室逸搏心律,4min出现短阵室速,
The patient, male, 86 years old, was hospitalized for 2 days because of recurrent palpitations and had a history of paroxysmal tachycardia more than 20 years.Physical examination: blood pressure 16 / 10kPa, conscious, stable breathing, heart rate 160 beats / min, Noise, no expansion of the heart bound, limbs without edema .Electrocardiogram (Figure A) showed supraventricular tachycardia (supraventricular tachycardia) .Diagnosis: paroxysmal supraventricular tachycardia .In admission 21 o’clock in the ECG within 5min under static Note heart rhythm 60mg + 10% glucose injection 20ml patients complained of systemic fever, ECG monitoring showed sinus rhythm, heart rate 97 beats / min, withdrawal immediately to maintain venous access, continue to observe the heart rate gradually slow after 15min, ECG (Figure B) showed border esophageal. Patients complained of abdominal discomfort, then limbs twitching, loss of consciousness, cardiac arrest, ECG cardioversion showed ventricular arrest (Figure C), immediately chest compression, oxygen, intravenous adrenal Prime 1mg, ventricular relaxation after 2min rhythm, 4min appear to have short-term VT,