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1 临床资料 19例院前急救病例中,男12例,女7例,年龄48～82岁,平均年龄62岁。14例伴有冠心病史。以劳累、情绪激动等为诱因,急性起病、憋气、咯泡沫样痰、端坐呼吸、剧烈头痛、唇绀、多汗为主要症状。血压185/120～290/150 mmHg,其中舒张压>130 mmHg者10例。伴一过性黑蒙、神志恍惚者13例。伴胸前闷胀样疼痛者6例。伴双下肢水肿者6例。查体一般情况较差,双肺闻及干湿罗音,湿性为主。心率>100次/min,有吹风样杂音或奔马律。EKG示心肌缺血或左室劳损。一经确诊,即予吸O_2、镇静,取酚妥拉明3～5 mg加液稀释至20～40 ml,5～10分钟内缓慢静注,然后再取7～20 mg入500 ml液体中静滴。15分钟测血压1次。无效时再予利尿、强心等措施。19例
1 Clinical data 19 cases of prehospital emergency cases, 12 males and 7 females, aged 48 to 82 years, mean age 62 years. 14 cases with coronary heart disease history. To fatigue, agitation and other incentives, acute onset, suffocation, slightly foamy sputum, sitting and breathing, severe headache, cyanosis, hyperhidrosis as the main symptoms. Blood pressure 185/120 ~ 290/150 mmHg, including diastolic blood pressure> 130 mmHg in 10 cases. With a dark, trance in 13 cases. Boring with chest pain like those in 6 cases. Six patients with bilateral lower extremity edema. General poor physical examination, lungs smell wet and dry rales, mainly wet. Heart rate> 100 beats / min, a hair-like noise or gallop. EKG showed myocardial ischemia or left ventricular strain. Once diagnosed, that is to absorb O2, sedative, take phentolamine 3 ~ 5 mg diluted with liquid to 20 ~ 40 ml, 5 ~ 10 minutes slow intravenous injection, and then take 7 ~ 20 mg into 500 ml of liquid medium drop. 15 minutes measuring blood pressure 1 time. Invalid when to diuretic, cardiac and other measures. 19 cases