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患者,男,46岁,为抢救被围困在深井爆炸后现场的工作人员,吸入爆炸后产生的尘雾15分钟左右,出现乏力、大汗、呼吸困难,急到当地医院就诊,吸氧1小时后返家。第二天凌晨再次出现上述症状,且加重,伴有咯大量黄痰、胸痛、发烧(37.5～38.5℃)。午后3时许转我院就诊。当时查体:神志清,Bp110/70mmHg,R24次/分,口唇轻度发绀,双肺呼吸音粗糙,血气分析:pH7.442、PCO_236.3mmHg、PO_241.2mmHg、SaO_279.5％,胸片:两肺可见弥漫性分布片絮状密度增高,边缘模糊影。初步诊断:急性吸入性肺损伤。给予抗生素、鼻导管吸氧。晚7时病人喘憋
The patient, male, 46 years old, rescued the workers trapped in the scene after the deep well explosion and inhaled the dust and fog generated after the explosion for about 15 minutes. The patient appeared weak, sweating and breathing difficulties. He was hurried to the local hospital for treatment and after 1 hour of oxygen inhalation Back home. The next morning the above symptoms again, and aggravated, accompanied by a slight amount of yellow sputum, chest pain, fever (37.5 ~ 38.5 ℃). 3 o’clock in the afternoon to go to our hospital. At that time physical examination: conscious, Bp110 / 70mmHg, R24 beats / min, lips mild cyanosis, lung breath sounds rough, blood gas analysis: pH7.442, PCO_236.3mmHg, PO_241.2mmHg, SaO_279.5% Diffuse distribution of both lungs visible flakes density increases, the edge of the fuzzy shadow. Initial diagnosis: acute aspiration lung injury. Given antibiotics, nasal catheter oxygen. 7 o’clock the patient wheezing