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患者男,60岁,以发作性心前区闷痛3年、加重3月之主诉于1991年2月25日入院。查体:T36℃,P72次/min,R18次/min,BP20/12kPa,体重60kg,神志清楚,半卧位,颈静脉无怒张,肝颈回流征(-),双肿呼吸音正常,心率85次/min,律齐,A_2>P_2,肝肋下4cm,质软,无压痛,脾脏未触及,腹水征(-),双下肢轻度凹陷性水肿。心电图提示:慢性冠脉供血不足。入院诊断:冠心病、不稳定型心绞痛、心功能Ⅲ级。在住院治疗期间,患者于3月7日上午9时自感胸闷加重。心电图为“偶发室性早搏”,遵医嘱给利多卡因50mg 静脉推注,早搏消失。次日上午9时病人又出现胸
Male patient, 60 years old, with episodes of premarital boring pain for 3 years, aggravating the main complaint in March 25, 1991 admission. Physical examination: T36 ℃, P72 times / min, R18 times / min, BP20 / 12kPa, weight 60kg, conscious clear, semi-recumbent, without jugular vein engorgement, liver reflux syndrome (- Heart rate 85 beats / min, law Qi, A_2> P_2, liver ribs 4cm, soft, no tenderness, spleen not touched, signs of ascites (-), mild depression of both lower extremity edema. ECG prompts: chronic coronary insufficiency. Admission diagnosis: coronary heart disease, unstable angina, heart function Ⅲ grade. During hospitalization, the patient experienced increased chest tightness at 9 am on March 7. ECG as “premature ventricular premature beats,” prescribed 50mg intravenous injection of lidocaine, premature beats disappear. The next morning the patient appeared chest again