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硝酸甘油舌下含服是治疗冠心病、心绞痛的一种药物,在临床上广为应用。最近,我们遇到一例应用硝酸甘油后,引起的血压下降,过敏性休克的病例,现报告如下: 患者,女性,62岁,85年4月4日16:30急诊入院。其家属代诉:患者患冠心病10余年,未曾治疗。4日下午自感心前区不适,16:00舌下含服硝酸甘油0.5mg,约七分钟后,出现面色苍白,胸闷,气短,心悸,咽部紧缩,有濒死感,旋即意识模糊,舌硬,16:30急诊出院。血压50/40mmHg,脉膊130次/分,呼吸30次/分,体温35.8℃,面部呈片状红色皮疹,双眼睑及面部浮肿,心电图显示“左心室肥厚劳损”,诊断为“过敏性休克”。立即给予平卧,吸氧,肌注肾上腺素0.2mg,强力解毒敏4ml。5％葡萄糖100ml+地塞米松10mg静注;静脉输入含糖盐
Sublingual nitroglycerin is a treatment of coronary heart disease, angina pectoris, a widely used in clinical practice. Recently, we encountered a case of nitroglycerin, the resulting drop in blood pressure, anaphylactic shock cases are reported as follows: Patients, females, aged 62, April 4, 85, 4:30 emergency admission. His family members sue: patients suffering from coronary heart disease more than 10 years, has not been treated. On the afternoon of the 4th, he felt uncomfortable in front of the area, 16:00 sublingual nitroglycerin 0.5mg, about seven minutes later, pale, chest tightness, shortness of breath, palpitations, throat tightening, sense of impending morbidity immediately blurred immediately tongue Hard, 16:30 emergency discharge. Blood pressure 50 / 40mmHg, pulse 130 beats / min, breathing 30 beats / min, temperature 35.8 ℃, the face was flaky red rash, double eyelid and facial edema, ECG showed “left ventricular hypertrophy strain”, diagnosed as “anaphylactic shock ”. Immediately give supine, oxygen, intramuscular injection of epinephrine 0.2mg, powerful detoxification sensitive 4ml. 5% glucose 100ml dexamethasone 10mg intravenous infusion of sugary salt