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循环系统疾病 - PowerPoint PPT Presentation


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循环系统疾病. 哈尔滨医科大学护理学院 内科护理教研室 林 平. 病例讨论. 病史摘要. 李 x ,男, 48 岁,恶心、呕吐、上腹部不适 1d 入院。询问病史,病人于发病前一晚上进食大量海鲜,且饮白酒 300ml ,餐后感到腹胀不适,自服 “ 环丙沙星 ” 、吗丁啉等药物,继续与同事玩牌。期间呕吐数次,呕吐物为当餐进食的胃内容物,量少,无腹泻。凌晨病人上腹疼痛加重、 胸闷, 遂来院就诊。. QUESTION?. 根据目前所获病史资料,对病人的初步印象诊断是什么? 还需进一步询问哪些情况或者采取哪些检查 ?. 病史摘要.

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循环系统疾病

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x481d300ml


QUESTION?

  • ?


6

T38.5 P54/ R18/ Bp112/60mmHg


1

5-6h/d

6



  • WBC12.7X109-CK 386ULCKMB40l U/L

  • ST IIIIIaVF1.2-1.5mVT


QUESTION?

  • ?


  • (AMl)

  • ST II IIIaVF12--15mVCK 386ULCKMB40l U/L


Myocardial Infarction, MI


myocardial infarction

STST


1




2


3

4


  • QQSTT

  • RSTT


EKG Changes




V1V2V3


II III aVF


V1-V5


CK-MB 4h16~24h 3~4d

CK 6h 24h 3~4d

AST 6~12h24~48h 3~6d

cTnI 3~4h 11~24h 7~10d

cTnT 3~4h 24~48h 10~14d

2h 12h 24~48h




?

  • :

  • :

  • :

  • :


1


2

  • 320/20mmHg630/30mmHg


3

1PCI

2

3





4.

R on T


5.


6.




""


QUESTION?

1.?

2.CCU(UK)1500 000U30min?


  • ()


(1)

23

24h/


  • (2)2h30 min18

  • (3)24h05h1


(4)

  • 2h

  • 2hST50

  • 2h


NO!

?




  • ?


  • ?

  • ?



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