论文部分内容阅读
例1,患者女,70岁,因恶心呕吐伴上腹不适1h,在某乡镇卫生院诊为急性胃炎,给5% GS 250ml,胃复安30mg,5% GNS250ml,庆大霉素24万 u 静滴,2h 后症状未缓解而收院。体检:T37℃,P110次/min,R25次/min,BP140/85 mmHg,神清,精神可,心音低钝,律整无杂音,双肺呼吸音清未闻及干湿哕音。腹软无压痛,肠鸣音正常,经 ECG 示 V_1～V_3ST 段呈凹面向上抬高(0.3～0.5 mV),T 波直立,CK-MB 850u/L,cTnT 3μg/L,诊为急性前壁心肌梗死,心源性休克。给溶栓、抗凝、扩冠、β受体阻滞剂、抗血小板聚集等治疗7d,痊愈出院。例2,患者女,68岁,因恶心呕吐3h 在某诊所诊为急性胃炎,给以甲氰咪胍0.8g,胃复安30mg,庆大霉素24万 u 分别静滴,因效果欠佳1h 后入我院就诊。查体:T36.9℃,P 120次/min,R28次/min,BP 80/50 mmHg,神清,精神差,面色苍白,四肢
Case 1, female, 70 years old, due to nausea and vomiting with abdominal discomfort 1h, diagnosed as acute gastritis in a township hospital, to 5% GS 250ml, metoclopramide 30mg, 5% GNS250ml, gentamicin 240000 u Intravenous infusion, 2h after the symptoms did not ease and admission. Physical examination: T37 ℃, P110 times / min, R25 times / min, BP140 / 85 mmHg, Shen Qing, spiritual, low heart sound blunt, law no noise, breath sounds clear lungs and wet and dry 哕 sound. Abdominal tenderness without tenderness, bowel sounds normal, the ECG showed V_1 ~ V_3ST segment was concave up (0.3 ~ 0.5 mV), T wave upright, CK-MB 850u / L, cTnT 3μg / L, diagnosed as acute anterior wall Myocardial infarction, cardiogenic shock. Thrombolysis, anticoagulation, crown expansion, β-blockers, anti-platelet aggregation and other treatment 7d, discharged. Example 2, female patient, 68 years old, vomiting due to nausea and vomiting 3h in a clinic diagnosed as acute gastritis, to give cimetidine 0.8g, metoclopramide 30mg, gentamicin 24 million u intravenous infusion, due to poor results After 1h into our hospital. Physical examination: T36.9 ℃, P 120 times / min, R28 times / min, BP 80/50 mmHg, Shen Qing, poor spirit, pale, limbs