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例1 男,45岁,因进食海鲜后3小时下腹胀痛,全身剧痒,伴有胸闷、心悸、头晕,发病3个半小时后急诊。体检:体温37.5℃,脉搏160次/分,血压16/11kPa,全身皮肤潮红,可见风团样皮疹。心率160次/分,律整齐,各瓣膜区未闻及病理性杂音,双肺呼吸音清,腹软,左下腹轻度压痛,肠鸣音亢进。化验室检查:白细胞总数12×10~9/L,分类:中性粒细胞0.60,淋巴细胞0.36,嗜酸性粒细胞0.04。心电图示:室上性阵发性心动过速。诊断:荨麻疹伴室上性阵发性心动过速。经59g/L葡萄糖盐水1000ml,地塞米松20mg,氯化钾2g静滴,5小时后,胸闷心悸消失,复查心电图:窦性心律,心率76次/分。例2 女,20岁,因洗衣服双手在冷水中浸泡半小时后发病,首先双手发痒,续而胸部
Example 1 Male, 45 years old, abdominal pain due to eating 3 hours after eating seafood, systemic itching, chest tightness, palpitations, dizziness, emergency 3 and a half hours after onset. Physical examination: body temperature 37.5 ℃, pulse 160 beats / min, blood pressure 16 / 11kPa, systemic skin flush, visible wind group rash. Heart rate 160 beats / min, law and tidy, the valve area is not known and pathological murmur, lung breath sound clear, abdominal soft, mild left lower quadrant tenderness, bowel sounds hyperthyroidism. Laboratory tests: the total number of leukocytes 12 × 10 ~ 9 / L, classification: 0.60 neutrophils, lymphocytes 0.36, eosinophils 0.04. ECG shows: supraventricular paroxysmal tachycardia. Diagnosis: urticaria with supraventricular tachycardia. After 59g / L glucose saline 1000ml, dexamethasone 20mg, potassium chloride 2g intravenous infusion, 5 hours later, chest tightness palpitations disappear, review of ECG: sinus rhythm, heart rate 76 beats / min. Example 2 Female, 20 years old, due to wash your hands soaked in cold water for half an hour after the onset of disease, first of all hands itching, continued chest