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临床资料患者,男,61岁,农民,进食哽咽感2个月。胃镜示:胃角胃窦部小弯侧溃疡浸润癌,于2004年4月16日入院。查心肺(-)。于2004年4月18日9:30在全麻下作胃癌切除术,肿块5.0×9.0×3.5cm,麻醉效果一般,行食管-胃弓下吻合术,手术顺利,生命体征平稳,出、渗血250 ml,未输血,输液1500 ml,尿量60 ml,于11:30关胸结束手术。11:35患者作翻身时突然心跳骤停,出现心室颤动,立即做胸外心脏按压.电击除颤3次(200～360 J),肾上腺素1mg、2mg、3mg 间断静脉注射,再次电击除颤3次,仍为心室颤动,继续控制呼吸并行胸外心脏按压、头部降温,速尿、地塞米松治疗无效。11:45再次开胸,用右手握着心脏,拇指在上、无名指在下作直接心脏挤压,节律为80次/min,两名术者10 min 轮换1次,可见患者颈动脉、股动脉博动。心电
Clinical data Patient, male, 61 years old, farmer, eating choking feeling 2 months. Gastroscopy showed: Gastric corner of the lesser curvature of the gastric antrum ulcer invasive cancer, on April 16, 2004 admission. Check cardiorespiratory (-). At April 30, 2004, at 9:30 on April 18, 2004 under general anesthesia for gastric cancer resection, mass 5.0 × 9.0 × 3.5cm, general anesthesia, line esophageal-gastric anastomosis, the operation was smooth, smooth vital signs, out, seepage Blood 250 ml, no blood transfusion, infusion 1500 ml, urine output 60 ml, closed surgery at 11:30 closed chest. 11:35 Sudden cardiac arrest with ventricular fibrillation and immediate thoracentricular compression in patients with a stand-in, electric defibrillation 3 times (200-360 J), epinephrine 1 mg, 2 mg, 3 mg intermittent intravenous injection, re-defibrillation 3 times, still ventricular fibrillation, continuous control of chest and chest compression, head cooling, furosemide, dexamethasone treatment ineffective. 11:45 chest open again, with the right hand holding the heart, the thumb in the ring finger under the direct cardiac squeeze, rhythm of 80 beats / min, the two surgeons 10 min rotation 1, showing the patient carotid artery, femoral artery Bo move. ECG