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笔者在临床工作中遇到2例顽固性心衰患者,一般处理效果不著,试用氯丙嗪治疗,效果较好,现报告如下。例1 杜某某,男,33岁,住院号158018。因劳累性心慌、气短10年,加重5天,于1984年6月8日入院。查体:血压124/80mmHg,脉搏90次/分,半坐位,颈静脉怒张,右腋下及肩胛下可闻干、湿罗音,心界向左下扩大,心率90次/分,律齐,心尖部Ⅲ—Ⅳ级双期杂音,腹软,肝大4cm,脾未及,双下肢中度可凹性水肿。诊断:风温性心脏病,二尖瓣狭窄及关闭不全,心力衰竭Ⅲ°,心功能Ⅳ级。入院后经强心、利尿、消心痛等治疗无好转,当晚11点20分出现急性肺水肿症状,给西地兰、速尿、心痛定、氢化考的松、多巴胺等,仍不缓解。患者烦躁,端坐呼吸,血压140/80mmHg,心率125次/分,两肺满布湿罗音,加用氯丙嗪12.5mg肌注,约20分钟后患
I encountered in clinical work of 2 patients with refractory heart failure, the general treatment is not effective, try chlorpromazine treatment, the effect is better, are as follows. Example 1 Du Moumou, male, 33 years old, hospital number 158018. Because of fatigue palpitation, shortness of breath 10 years, increased 5 days, on June 8, 1984 admission. Physical examination: blood pressure 124 / 80mmHg, pulse 90 beats / min, half-sitting, jugular vein engorgement, right axilla and subscapularis can be heard dry, wet rales, heart bound to the lower left, heart rate 90 beats / min, , Apex Ⅲ-Ⅳ level two-phase murmur, abdominal soft, liver 4cm, spleen and the lower extremity moderate concave edema. Diagnosis: Wind-induced heart disease, mitral stenosis and insufficiency, heart failure Ⅲ °, Ⅳ grade heart function. Admission cardiac cardiac, diuretic, anti-heartache and other treatment did not improve after admission, 11:20 that night acute pulmonary edema symptoms, to cedilanol, furosemide, nifedipine, hydrocortisone, dopamine, etc., are still not relieved. Patients with irritability, sitting breathing, blood pressure 140 / 80mmHg, heart rate 125 beats / min, both lungs full of moist rales, plus chlorpromazine 12.5mg intramuscular injection, about 20 minutes later