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张某某,女性,45岁,患风湿性心脏病10余年,多次心衰,近5天气喘,不能平卧。血压150/100毫米汞柱,心尖部有Ⅲ级吹风样和隆隆样杂音,肝大肋下4横指,中等硬度,两下肢有指凹性浮肿。在纠正心衰时,静脉缓注细胞色素丙15毫克(溶于25%葡萄糖液40毫升中)以纠正组织缺氧。注射毕,患者即感眼胀、胸闷、呼吸困难、头颈部热胀、头晕、恶心、呕吐、四肢麻木、无力。并面色苍白、烦躁不安,眼结膜充血,血压速降而测不出,全身出现黄豆大小斑丘疹。立即皮下注射肾上腺素1毫克,10分钟后,血压上升至66/46毫米汞柱,2小时后血压为110/70毫米汞柱,同时肌肉注射苯海拉明40毫克,3小时后皮疹渐渐消退。
Zhang Moumou, female, 45 years old, suffering from rheumatic heart disease more than 10 years, many heart failure, asthma in the past 5 days, can not lie down. Blood pressure 150/100 mm Hg, apical hair with a class and rumble-like noise, large four-fingered liver ribs, moderate hardness, both lower extremity have concave edema. In correcting heart failure, intravenous infusion of cytochrome C 15 mg (dissolved in 25% glucose solution 40 ml) to correct tissue hypoxia. Injection Bi, the patient is feeling eye swelling, chest tightness, difficulty breathing, head and neck dilation, dizziness, nausea, vomiting, limb numbness, weakness. And pale, irritability, conjunctival hyperemia, blood pressure drop can not be measured, the body appeared spotted rash of soybean size. Immediate 1 mg of epinephrine was injected subcutaneously. After 10 minutes, the blood pressure rose to 66/46 mm Hg. After 2 hours, the blood pressure was 110/70 mmHg. Simultaneously, 40 mg of diphenhydramine was administered intramuscularly. After 3 hours, the rash subsided .