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患者,男,61岁。因发作性胸痛、腹痛1周,再发3 h余,于2011年9月12日入院。于1周前晨起后无明显诱因突发胸痛、腹痛,为胸骨下段后及上腹剑突下隐痛,持续不缓解,阵发性加重,伴出汗,恶心、呕吐胃内容物数次,无咖啡渣样物,无发热、腹泻、黑便,在当地医院就诊,查心肌肌钙蛋白I阴性,血尿淀粉酶正常,B超示肝胆脾胰未见明显异常,胃镜检查示浅表性胃炎,慢性食管炎,考虑为胃炎,给予对症处理后症状好转,未进一步检查治疗。就诊日早7:00患者起床后无明显诱因再次突发胸痛、腹痛,仍为胸骨下段后
Patient, male, 61 years old. Due to episodes of chest pain, abdominal pain for 1 week, more than 3 h recurrence, on September 12, 2011 admission. No significant incentive after 1 week before onset Sudden chest pain, abdominal pain, lower sternum and the upper xiphoid pain, continued to not relieve, paroxysmal increase, accompanied by sweating, nausea, vomiting, stomach content several times, no coffee Slag samples, no fever, diarrhea, melena, treatment at a local hospital, check cardiac troponin I negative, normal amniotic fluid amylase, B ultrasound showed no abnormal liver, spleen and pancreas, gastroscopy showed superficial gastritis, chronic Esophagitis, considered as gastritis, symptomatic treatment to give symptomatic improvement, no further examination and treatment. 7:00 am as soon as possible after treatment, patients with no obvious incentive to get up again chest pain, abdominal pain, still after the sternum