论文部分内容阅读
患者,女,49岁,因胸闷气急14h于1985年11月19日11∶40am急诊入院。入院前一天晚间劳动后卧床不久,突感胸闷,呼吸极度困难;濒死,遂入当地医院,测血压25.6/17.3kPa,按高血压病治疗,症状缓解即转本院。既往有血压升高病史5年。入院检查:神清,血压18.7/12.0kPa,脉率82次。当开始陈述瘸史时(11∶50am),突然呈喘息性呼吸,意识丧失,两眼上窜,短暂抽搐后面色紫绀,呼吸停止,心音及大动脉搏动消失。诊断:高血压性心脏病并循环呼吸骤停。立即行心前区叩击,无效,转而以90次/min左右的频率行胸外心脏按压,同时心内注射肾上腺素1mg,3min后其自主呼吸恢复,但仍未闻及心音,继之氧吸入,于12∶5am心电图检查提示心室颤动,立即
The patient, female, 49 years old, was hospitalized for emergency at chest tightness 14h at 11:40am on November 19, 1985. Nearly one day before hospitalization, after working in the bed for a long time, the patient felt sudden chest tightness and extreme difficulty in breathing. The patient died on the verge of death and went to a local hospital to measure blood pressure 25.6 / 17.3kPa. Past history of hypertension 5 years. Admission examination: God clear, blood pressure 18.7 / 12.0kPa, pulse rate 82 times. When the beginning of lame history (11:50 am), suddenly breathing wheezing, loss of consciousness, eyes up channeling, short-term seizures cyanosis, respiratory arrest, heart sounds and aortic pulse disappeared. Diagnosis: Hypertensive heart disease and respiratory arrest. Immediate perioperative area percussion, invalid, in turn to the frequency of 90 times / min chest compression outside the heart, while intra-cardiac injection of epinephrine 1mg, 3-year spontaneous breathing recovery, but still no heart sound, followed by Oxygen inhalation, at 12:5 am ECG prompted ventricular fibrillation, immediately