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1 病例摘要 患者男,45,因饮酒6两后半小时突感心悸、胸闷、四肢无力入院,平素健康。入院查体:KT36.4℃.P54次/11KPa,一般状态稍差,嗜睡状态,口唇无发绀,颈静脉无怒张,双肺呼吸音清,无干湿罗音,心界无扩大,心率54次/分,律不齐、稍弱,各瓣膜区未闻及病理性杂音,肝脾未触及,双下肢无浮肿。入院当天心电图:窦性心动过缓伴不齐,窦房结一交界区游走性心律,等频性不完全性干扰性房室脱节,频发室早,加速性多形性室性逸搏。入院后查血常规、血脂、血糖、肝功正常,胸片及心脏多普勒均正常,临床诊断乙醇中毒心律失常,给予静注利多卡因50毫克,以2.4mg/分维持,阴托品、能量合剂等治疗,病人症状渐渐改善,8小时后心电图:窦性心动过缓,心率56次/分,住院7天,出院前心电图正常。
1 case summary Male patients, 45, 6 hours after drinking for six hours suddenly felt palpitations, chest tightness, limb weakness hospitalized, usually healthy. Admission examination: KT36.4 ℃. P54 times / 11KPa, the general state of slightly worse, lethargy state, no cyanotic lips, neck jerk, lung breath sounds clear, no dry and wet rales, no expansion of the heart, heart rate 54 beats / min, the law is not homogeneous, a little weaker, the valve area is not known and pathological murmur, liver and spleen not touched, no swelling of both lower extremities. On the day of admission ECG: sinus bradycardia with missing, sinoatrial junction of a walk in the rhythm of the heart, the frequency of incomplete disruption of atrioventricular anomalies, frequent premature ventricular contractions, accelerated pleomorphic ventricular esophageal . After admission to check blood, blood lipids, blood glucose, normal liver function, chest and heart Doppler are normal, clinical diagnosis of alcohol poisoning arrhythmia, given intravenous lidocaine 50 mg to 2.4mg / min to maintain, , Energy mixture and other treatment, the patient’s symptoms gradually improved, 8 hours after the ECG: sinus bradycardia, heart rate 56 beats / min, hospitalized 7 days, pre-discharge ECG is normal.