论文部分内容阅读
自发性气胸是常见急症,胸腔穿刺抽气是治疗该病简便有效的方法。近一年来笔者曾遇2例自发性气胸患者,在胸穿抽气治疗过程中突然出现头晕、心慌、大汗、血压下降,即胸膜性休克。立即停止抽气及对症处理后恢复。现报道如下。例1,男,26岁。因左侧胸痛、胸闷2天入院。查体:T37.3℃,P92次/min,R22次 min,BP:14/9kPa。左胸廓饱满,语颤减弱,叩诊呈鼓音,左肺呼吸音低。X 线胸片示左侧自发性气胸,肺组织压缩约60%。入院后予胸穿抽气治疗,当抽气约50ml 时,突现头晕、心慌、面色苍白、大汗淋漓、四肢厥冷,脉搏不能触及,神志不清,血压0/0kPa,心率30次/min,心音低钝。立即停止抽气,使患者去枕平卧,吸氧,肌注阿托品 lmg。3分钟后心跳、神志逐渐恢复正常。次日患者肌注阿托品 lmg,并消除其精神紧张情绪。10
Spontaneous pneumothorax is a common emergency, pleural puncture aspiration is a simple and effective treatment of the disease. In the past year I have encountered two cases of patients with spontaneous pneumothorax, sudden dizziness, palpitation, sweating, blood pressure, pleural shock in the process of chest wear exhaust. Stop pumping and symptomatic treatment immediately after recovery. Report as follows now. Example 1, male, 26 years old. Due to left chest pain, chest tightness 2 days admission. Physical examination: T37.3 ℃, P92 times / min, R22 times min, BP: 14 / 9kPa. Left thorax full, tremor weakening, percussion was drum sound, left lung breath sounds low. X-ray showed left spontaneous pneumothorax, lung tissue compression about 60%. After admission to the chest wearing suction treatment, when about 50ml of suction, the sudden dizziness, palpitation, pale, sweating, extremities Jueleng, pulse can not touch, unconsciousness, blood pressure 0 / 0kPa, heart rate 30 beats / min , Low heart sound blunt. Stop pumping immediately, so that patients to pillow supine, oxygen, intramuscular injection of atropine lmg. After 3 minutes heartbeat, consciousness gradually returned to normal. The next day patients with intramuscular injection of atropine lmg, and to eliminate their mental stress. 10