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患者:男,76岁。因“反复咳嗽咯痰16年多,心累气紧3年多,加重1月”入院。入院前曾有“核糖霉素”过敏史。查体:T36.5℃,P90次/分,R21次/分,BP21/9.5kPa。诊断:双下肺炎,肺气肿。入院当天在先锋霉素Ⅵ皮试阴性后,用先锋霉素Ⅵ5.0g加5％GS150ml静滴,25滴/分,给药5分钟后,患者出现呼吸急促,心慌,频死感。急查体:BP36/14kPa(入院测值为21/9.5kPa),P130次/分,R28次/分。急性危病容,端坐呼吸,面部潮红,球结膜水肿,全身皮肤出现大小不等的红斑,压之不退色。心率130次/分,律齐,满肺哮鸣音及中等量水泡音。立即停输先锋霉素Ⅵ,同时吸氧,静注地塞米松10mg,肌注非那根25mg,接着用地塞米松10mg加5％GS50ml,5分钟后患者气促心慌症状开始缓解,但血压仍高达30/13kPa,故舌下含化心痛定10mg,静注速尿20mg,同时用硝酸甘油10mg加50％GS100ml,30分钟后血压降至26/11.5kPa,
Patient: Male, 76 years old. Because of “repeated coughing sputum more than 16 years, tired heart tight 3 years, aggravating January” admission. There was a history of “ribavirin” allergy before admission. Physical examination: T36.5 ℃, P90 beats / min, R21 beats / min, BP21 / 9.5kPa. Diagnosis: double pneumonia, emphysema. On the day of admission, after the Vanguard ADM Ⅵ skin test negative, with Pioneer vims Ⅵ5.0g plus 5% GS150ml intravenous infusion, 25 drops / min, 5 minutes after administration, patients with shortness of breath, palpitation, frequent death feeling. Emergency examination: BP36 / 14kPa (hospital admission was 21 / 9.5kPa), P130 beats / min, R28 beats / min. Acute critical illness, sitting breathing, facial flushing, conjunctival edema, the body skin appears erythema of varying sizes, the pressure of fade. Heart rate 130 beats / min, law Qi, full lung wheezing and moderate volume of blisters sound. Immediately stop the Pioneer ADM Ⅵ, while oxygen, intravenous injection of dexamethasone 10mg, intramuscular injection of non-root 25mg, followed by dexamethasone 10mg plus 5% GS50ml, 5 minutes after the patient began to relieve symptoms of shortness of breath, but the blood pressure is still Up to 30 / 13kPa, the tongue sublingual nifedipine 10mg, intravenous furosemide 20mg, with nitroglycerin 10mg plus 50% GS100ml, 30 minutes after the blood pressure dropped to 26 / 11.5kPa,