孤立性右心室梗死31例临床观察

目的深入了解孤立性右心室梗死的临床特点、诊断和治疗。方法采用心电图右心导联V3R~V6R中至少有一个导联ST段抬高≥0.1mV,超声心动图示右心室扩大或节段性收缩减弱或消失及颈静脉怒张或Kussmanul氏征阳性的方法并通过冠脉造影诊断出近23年全部31例孤立性右心室梗死的病人,收入监护病房,给予溶栓、扩容、减轻心脏后负荷等治疗。结果31例病人中27例治愈出院,4例死亡。结论孤立性右心室梗死临床少见,掌握正确的诊断方法方能及时诊断,维持右心室的前负荷,减轻右心室的后负荷是治疗的关键。

Clinical Observation on 31 Patients with Isolated Right Ventricular Infarction

Objective To survey the clinical characteristics,diagnosis and treatment of isolated right ventricular infarction.Method A total of 31 patients with nearly 23 years of isolated right ventricular infarction were diagnosed by using diagnostic methods,including raising ST segment of at least one right ventricular lead on electrocardiogram(≥0.1mV),right ventricular expanding or segmental contraction weakening of right ventricle on ultrasonic cardiography,and jugular vein dilatation or positive Kussmanul's sign,as well as coronary angiocardiography.All patients were admitted to CCU and received thrombolysis,dilatancy and redution of right ventricular afterload.Results 27 of 31 patients recovered,4 patients died.Conclusions Isolated right ventricular infarction is rare clinically,which can be diagnosed only by correct diagnostic methods.The maintainance of preload and the reduction of afterload of right ventricle is the key to the treatment.