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患者女性,42岁,因心悸、胸闷5h急诊入院。5h前突然出现心悸、胸闷,经休息及屏气后未能好转。既往有多次类似发作史,曾多次作心电图,诊断为“室上性心动过速”。查体:血压16/10kPa,神清,两肺(一),心率180次/min,律齐,未闻杂音,腹(一)。心电图示室上性心动过速,心率186次/min。以心律平70mg(未经稀释)静注,边推边听心率,2min推完后未能复律,再予70mg静注,当推至35mg(总量105mg)时,患者诉头昏,继而心脏骤停,面色青紫,意识丧失,血压测不出。立即拳击心前区,吸O_2,地塞米松5mg静注,肾上腺素1mg肌肉注射等,约3min后心跳、呼吸及意识恢复,血压15/8kPa,呼吸18次/min,心率88次/min,律齐,观察一天无不适而出院。1个月后,因“室
Female patient, 42 years old, admitted to hospital due to heart palpitations, chest tightness 5h. 5h before sudden heart palpitations, chest tightness, after resting and breathless did not improve. Past history of many similar episodes, has repeatedly made electrocardiogram, diagnosed as “supraventricular tachycardia.” Physical examination: blood pressure 16 / 10kPa, Shen Qing, both lungs (a), heart rate 180 beats / min, law Qi, no unheard noise, abdomen (a). ECG supraventricular tachycardia, heart rate 186 times / min. Heart rate flat 70mg (undiluted) intravenous injection while listening to heart rate, push the end after 2min failed to cardioversion, and then 70mg intravenous injection when pushed to 35mg (total 105mg), the patient complained of dizziness, and then Cardiac arrest, bruising, loss of consciousness, blood pressure can not be measured. Immediately boxing precordial, inhalation O_2, dexamethasone 5mg intravenous injection, adrenaline 1mg intramuscular injection, about 3min after the heartbeat, breathing and consciousness recovery, blood pressure 15 / 8kPa, breathing 18 beats / min, heart rate 88 beats / min, Law Qi, observe the day without discomfort and discharged. After 1 month, due to "room