本文選題：電風(fēng)暴 + 心肌梗死��； 參考：《浙江大學(xué)》2014年碩士論文

【摘要】：患者,男性,71歲,既往前壁心肌梗死,左前降支支架植入術(shù)后,1年半前因陣發(fā)性室速植入單腔ICD。本次因突發(fā)寒戰(zhàn)高熱心前區(qū)刺痛(ICD放電)5-6次,入院后胺碘酮等控制心律,血培養(yǎng)提示大腸埃希菌,肺部CT示肺部感染,依據(jù)藥敏結(jié)果予美羅培南抗感染,入院3天后再發(fā)高熱寒戰(zhàn)時并發(fā)心室電風(fēng)暴,對癥降溫、靜推胺碘酮、硫酸鎂、地塞米松及異丙嗪后緩解,復(fù)查肺部CT提示肺實變,美羅培南繼續(xù)治療3周,血常規(guī),CRP,胸部CT以及血培養(yǎng)均恢復(fù)正常后改靜滴頭孢西丁治療2周出院�；颊叱鲈汉�4年內(nèi)未再發(fā)室速或室顫(ICD未報警)�；颊咝氖译婏L(fēng)暴均在敗血癥蔓延并發(fā)寒戰(zhàn)高熱時發(fā)生,考慮為敗血癥高熱引發(fā)全身交感興奮引發(fā)心室電風(fēng)暴可能性大。
[Abstract]:The patient, male, 71 years old, had anterior myocardial infarction, left anterior descending branch stent implantation, one and a half years ago because of paroxysmal ventricular tachycardia implanted single lumen ICD. The ICD discharge was 5-6 times due to sudden shivering and high enthusiasm. After admission, amiodarone was used to control cardiac rhythm, blood culture suggested Escherichia coli, lung CT showed pulmonary infection, and meropenem was given anti-infection according to the drug sensitivity results. After 3 days of hospitalization, ventricular electrical storm occurred during hyperthermia and shivering after admission. The symptoms were cooled down, amiodarone, magnesium sulfate, dexamethasone and promethazine were relieved. Pulmonary CT examination indicated pulmonary consolidation, and meropenem continued to be treated for 3 weeks. CRP, chest CT and blood culture were restored to normal and then were treated with cefoxitin intravenously for 2 weeks. No recurrent ventricular tachycardia or ventricular fibrillation was reported within 4 years after discharge. Ventricular electrical storms occurred when septicemia spread and chills and hyperthermia occurred. It was considered that systemic sympathetic excitation caused by septicemia and hyperthermia was more likely to cause ventricular electrical storms.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R515.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 Gurfinkel E.P.;Guerlloy F.P.;Mautner B.;馬超;;靜脈內(nèi)給予抗炎藥后可抑制危及生命的快速性心律失常和房室缺血性阻滯[J];世界核心醫(yī)學(xué)期刊文摘(心臟病學(xué)分冊);2007年05期

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