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我院抢救21例急性氨中毒,其中有心肌功能改变者12例,占57％,报告如下: 临床资料:本组21例均为遭受液氨中毒损害的现场工作人员。病员全部均在事后20分钟送来医院救治。入院当时对每例病员进行详细体查,均无器质性心脏病、气管炎、肝炎等。入院后3小时内普遍做心电图9个常规导联描记做为对照(个别加V_4V_6)。在中毒后8小时、24小时描记心电图,以后每日做心电图描记一次,两周后停止连续观察。个别观察到1月后。结果:中毒后8小时心电图开始出现变化。其主要改变有两种。1.急性肺心病样表现:高而尖肺型P波,P>2.5mV,Ⅰ导联出现深S波,Ⅲ导联出现Q波,但小于0.03秒,T波倒置呈S_Ⅰ,Q_Ⅱ,T_Ⅲ(-)型,而avF导联无异常Q波,只有q波,借此与下壁心肌梗塞鉴别。电轴右偏。偶而可出现不完全性或完全性右束枝传导阻滞。多数导联S-T段下移,T波倒置或低平。其改变随着病情好转,心电图也于两周
21 cases of acute ammonia poisoning were treated in our hospital, including 12 cases with changes of myocardial function, accounting for 57%. The report is as follows: Clinical data: All 21 patients in this group were on-site staff suffering from liquid ammonia poisoning. All patients were sent to hospital for treatment after 20 minutes. At the time of admission to each patient for a detailed investigation, no organic heart disease, tracheitis, hepatitis and so on. Within 3 hours after admission generally do 9 conventional ECG lead ECG as a control (individual plus V_4V_6). Eight hours after poisoning, electrocardiogram was recorded 24 hours later, electrocardiogram was performed once a day, and continuous observation was stopped after two weeks. Individual observation after January. Results: Eight hours after poisoning ECG began to change. There are two main changes. Acute pulmonary heart disease-like performance: high and sharp pulmonary P wave, P> 2.5mV, Ⅰ lead appeared deep S wave, Ⅲ lead appears Q wave, but less than 0.03 seconds, T wave inversion was S_Ⅰ, Q_Ⅱ, T_Ⅲ (-) type, and avF lead no abnormal Q wave, only q wave, to differentiate inferior wall myocardial infarction. Right deviation axis. Occasionally there may be incomplete or complete right bundle branch block. Most lead S-T segment down, T wave inversion or low level. The change as the condition improved, ECG also in two weeks