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患者女,31岁。因咯血1周入院。临床诊断:风湿性心脏病,二尖瓣狭窄,心功能Ⅱ级。体检:BP14/8kPa(105/60mmHg),二尖瓣面容,颈静脉轻度怒张,两肺呼吸音粗。心率100次/min,律齐,/心尖区闻及中等强度的舒张期杂音。入院心电图(附图A)示窦性心率97次/min,电轴+103°,P_(Ⅰ、Ⅱ、aVL、V_a-V_c)均为双峰P波,后峰高于前峰。P-R间期为0.14s。QRSv呈qRs型,R/s>1;V_2呈错综小波,R/s>1;V_5为rS型,r/S<1。心电图诊断:窦性心律,二尖瓣型P波,右心室肥大。治疗给予口服双氢克尿塞50mg,1次/天,安体舒通20mg,2次/天,静滴酚妥拉明后仍间断咯血。于入院第7天静注速
Female patient, 31 years old. 1 week due to hemoptysis admitted. Clinical diagnosis: rheumatic heart disease, mitral stenosis, heart function Ⅱ level. Physical examination: BP14 / 8kPa (105 / 60mmHg), mitral valve surface, mild jugular vein engorgement, both lungs sound rough tone. Heart rate 100 beats / min, law Qi, / apex area and moderate-intensity diastolic murmur. Admission electrocardiogram (Figure A) showed sinus heart rate 97 beats / min, electrical axis +103, P_ (Ⅰ, Ⅱ, aVL, V_a-V_c) are bimodal P wave, the latter peak higher than the former peak. P-R interval is 0.14s. QRSv was qRs type, R / s> 1; V_2 was complex wavelet, R / s> 1; V_5 rS type, r / S <1. ECG diagnosis: sinus rhythm, mitral P wave, right ventricular hypertrophy. Treatment given oral hydrochlorothiazide 50mg, 1 / day, spironolactone 20mg, 2 times / day, intravenous infusion of phentolamine still intermittent hemoptysis. On the first 7 days of admission intravenous speed