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低血钾Ⅲ°房室传导阻滞一例原平县第一人民医院（０３４１００）郭志康，贾培良患者男性，２１岁。因四肢软弱无力，伴心悸、胸闷１５天于１９９０年１２月２１日入院。半月前，无明显诱因出现四肢乏力、恶心、食欲差、伴多饮、多尿，劳累后出现心悸、胸闷。无发热、咳嗽及腹泻。既往体健，无类似发作。食棉籽油约９月余。近期无应用药物史。家族中无此病史。查体：Ｔ３６．５℃、Ｐ４８次／分、ＢＰ１６／１ｌ．８ｋＰａ，神志清晰，被动体位，抬头困难。双肺（一）。心率４８次／分，律齐，心音低钝，未闻及杂音。心界不大。腹：腹式呼吸消失。软，稍膨隆。压痛（一），肝、脾未触及。四肢肌张力低，肌力双上肢Ⅲ级，双下肢０级。两侧膝反射消失。病理反射（一）。实验室检查：血、尿、便常规均正常。血沉１６毫米／小时。空腹血糖５．ｌｍｍｏｌ／Ｌ。血清Ｋ＋２．ｌｍｍｏｌ／Ｌ、Ｎａ＋ｌ３２ｍｍｏｌ／Ｌ，Ｃｌ－ｌ４５ｍｍｏｌ／Ｌ，Ｃａ＋＋２．４ｍｍｏｌ／Ｌ，ＣＯ２ＣＰ２３ｍｍｏｌ／Ｌ。心电图示：窦性心动过速，Ⅲ°房室传导阻滞，交界性逸搏心律，各导联（除ａＶＲ外）ＳＴ段均呈上斜型下移０．０５～０．５ｍｍ，Ｔ波低平、双向，ｕ波增高。超声心动图正常。拟诊为低血钾软病伴Ⅲ°房
Hypokalemia Ⅲ ° atrioventricular block a case of the First People’s Hospital of Yuanping County (034100) Guo Zhikang, Jia Peiliang patients male, 21 years old. Due to limb weakness, palpitations, chest tightness 15 days in December 21, 1990 admission. Half a month ago, no obvious incentive to appear limb weakness, nausea, poor appetite, with more drinks, more urine, fatigue, palpitations, chest tightness. No fever, cough and diarrhea. Past physical health, no similar attack. Fresh cottonseed oil about 9 months. No recent history of drug use. No such history in the family. Physical examination: T36.5 ℃, P48 times / min, BP16 / 1l. 8kPa, clear-cut, passive posture, head up difficulties. Double lungs (a). Heart rate 48 beats / min, law Qi, low heart sound blunt, no smell and noise. Heart is small. Abdomen: abdominal breathing disappears. Soft, slightly bulging. Tenderness (a), liver, spleen not touched. Limb muscle tension is low, muscle strength of upper extremity Ⅲ, double lower extremity 0. Knee reflex on both sides disappeared. Pathological reflex (a). Laboratory tests: blood, urine, they are routinely normal. ESR 16 mm / h. Fasting blood sugar 5. lmmol / L. Serum K + 2. lmmol / L, Na + l32mmol / L, Cl-l45mmol / L, Ca ++ 2.4mmol / L, CO2CP23mmol / L. ECG showed: sinus tachycardia, Ⅲ ° atrioventricular block, junctional esophageal rhythm, each lead (except for aVR) ST segment were inclined down 0.05 ~ 0.5mm, T wave Low-level, two-way, u-wave increased. Echocardiography normal. To be diagnosed with hypokalemia and soft tissue disease with Ⅲ ° room