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甲亢危象伴Ⅲ度房室传导阻滞(Ⅲ°A-VB)临床少见,现将我院抢救成功1例报道如下。患者女性,22岁。入院前3个月起食纳奇佳,每天主食1公斤,但消瘦明显、多汗易怒。入院前食不洁食物后即频繁呕泻。当天体温39℃,夜间反复昏厥及暂短抽搐、意识丧失,急诊入院。体检:T39.5℃,P40次/分,BP19/9 kPa。谵妄、阵阵烦躁不安,双眼裂增大。两甲状腺肿大Ⅱ°,闻血管杂音。心界向左扩大,心率40次/分,闻大炮音,四肢温暖多汗。心电图示Ⅲ°A-VB 室性逸搏心律,心室率40次/分,心房率164次/分。体检时突然双眼上翻,四肢抽搐,口面青紫,意识丧失。心电描记心脏停搏10秒,经胸外心脏挤压复苏。即给异丙基肾上腺素、氢化可的松静滴,鼻饲他巴唑、甲基硫氧嘧啶及卢戈氏液,氨苄青霉素及庆大霉素抗感染。诊断:甲亢危象,甲亢性心脏病Ⅲ°A-VB,阿斯综合征,肠道感染。经以上处理,心室率50次/分,体温38℃,神志清,抽搐停止。第3天心电图为Ⅱ°A-VB(莫氏Ⅱ型)室率59次/分,房率
Hyperthyroid crisis with Ⅲ degree atrioventricular block (Ⅲ ° A-VB) clinical rare, now a successful case of hospital rescue reported as follows. Patient female, 22 years old. 3 months before admission Naoqi Jia, daily staple 1 kg, but weight loss significantly, more sweating irritability. Frequent vomiting after eating unclean food before admission. Body temperature 39 ℃, night fainting and transient convulsions, loss of consciousness, emergency admission. Physical examination: T39.5 ℃, P40 beats / min, BP19 / 9 kPa. Delirium, bursts of restlessness, eyes cracked. Two goiter Ⅱ °, smell the murmurs. Heart to the left to expand, heart rate 40 beats / min, smell cannon sound, extremities warm sweating. ECG showed Ⅲ ° A-VB ventricular rhythm, ventricular rate 40 beats / min, atrial rate 164 beats / min. Suddenly when the physical examination double-fold, limbs convulsions, bruising, loss of consciousness. Electrocardiogram Cardiac arrest for 10 seconds, the cardiopulmonary compression recovery. Namely, isoproterenol, hydrocortisone intravenous infusion of nasal methimazole, methylthiouracil and Lugol’s solution, ampicillin and gentamicin anti-infective. Diagnosis: hyperthyroidism crisis, hyperthyroidism heart disease Ⅲ ° A-VB, Asperger’s syndrome, intestinal infection. After the above treatment, ventricular rate 50 beats / min, body temperature 38 ℃, clear consciousness, convulsions stopped. On the third day ECG was Ⅱ ° A-VB (Mohs Ⅱ type) room rate 59 beats / min, room rate