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下肢深静脉血栓(DVT)合并大块急性肺动脉栓塞有很高的病死率,我院成功抢救1例,现报告如下。患者,男性,63岁,农民。因Ⅲ型肺结核在当地医院住院治疗1月余,出现左下肢肿胀、疼痛10 d,到我院就诊。体检左下肢全肢肿胀,左大腿中段周径较右侧粗4 cm,小腿上段周径较右侧粗2cm,Honum’s征阳性。彩色多普勒超声检查提示:左下肢DVT。该患者人院时,体温:36 8℃,BP 150/80 mm Hg,心率:80次/min。给予抗凝、溶栓、祛聚、抗生素预防感染治疗;行NS 250 ml+尿激酶加万u静脉滴入。约1 min后患者即诉胸背部剧烈疼痛,随即出现呼吸困难、胸闷、心慌、面部及口唇紫绀,全身皮肤湿
Lower extremity deep vein thrombosis (DVT) with massive acute pulmonary embolism has a high mortality rate, the hospital successfully rescue 1 case, are as follows. Patient, male, 63 years old, farmer. Because of type III pulmonary tuberculosis in the local hospital for more than 1 month, left leg swelling, pain 10 d, to our hospital. Physical examination of the left lower limb swelling of the whole limb, the left middle thigh than the right side of the rough 4 cm, upper leg circumference than the right rough 2 cm, Honum’s sign positive. Color Doppler ultrasound examination Tip: left leg DVT. The patient was hospitalized, body temperature: 368 ℃, BP 150/80 mm Hg, heart rate: 80 beats / min. Given anticoagulant, thrombolysis, dispel poly, antibiotics to prevent infection; line NS 250 ml + urokinase plus million u intravenous infusion. About 1 min after the patient complained of severe chest and back pain, followed by breathing difficulties, chest tightness, palpitation, facial and lip cyanosis, systemic skin wet