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患者女,46岁。以风心病、二尖瓣狭窄及关闭不全(以狭窄为主)、房颤、心衰Ⅲ°,于1987年11 月29日入院。经强心、利尿和对症治疗一周后病情明显好转,心衰基本纠正。12月7日下午一时,下床活动时突感左下肢剧烈疼痛,足部更甚。检查:左足部皮肤苍白,小腿下段至左足皮肤温度减低,左侧腘动脉搏动存在,足背动脉搏动消失。诊断为左下肢动脉栓塞。立即抬高床头约20cm,肌注杜冷丁100mg。一小时后疼痛暂时减轻,但患肢上述局部体征无变化。当日下午三时开始左股动脉内注射1%的肝素10ml,每日二次。左下肢同时施以超声波理疗,每日两次每次30分钟。第二日中
Female patient, 46 years old. To rheumatic heart disease, mitral stenosis and insufficiency (mainly stenosis), atrial fibrillation, heart failure Ⅲ °, was admitted on November 29, 1987. After cardiac, diuretic and symptomatic treatment significantly improved after a week, heart failure, the basic correction. On the afternoon of December 7, at 1 o’clock on the afternoon of December 7th, they suddenly felt severe pain in the lower extremities when they got out of bed and their feet were even worse. Check: the left foot pale skin, leg lower leg skin temperature to reduce the left pulsating pulsation exists, the dorsalis pedis artery pulse disappeared. Diagnosis of left lower extremity arterial embolism. Immediately raise the bed about 20cm, intramuscular injection of pethidine 100mg. After an hour of pain temporarily reduced, but the affected limbs above the local signs no change. The left femoral artery injection of 1% heparin 10ml twice daily at 3:00 pm the same day. Left lower extremity simultaneously applied ultrasonic therapy, twice a day for 30 minutes each time. The second day