论文部分内容阅读
女患,79岁。因活动后胸闷、心慌2年。加重10天于1991年4月25日入院。诊断:冠心病,频发多源性室性早搏。入院后按冠心痛常规治疗,并给利多卡因50毫克静注,又以每分钟1毫克静滴维持,日总量600毫克。第2日患者出现嗜睡,夜间转入昏迷,无恶心、呕吐,无发热,无抽搐。查体:血压18/11千帕。深昏迷,呼吸正常,双侧瞳孔直径3毫米,对光反射灵敏,颈无抵抗,双肺正常,心率>76次/分,闻及较频发早搏,心脏无杂音,肝脾未扪及,克氏征、布氏征均阴性,神经病理反射未引出。心电图示:频发室性早搏,多导联T彼低平,ST段压低。脑脊液及其他实验室多项检查未见异常。故以昏迷原因待查加用中枢神经兴奋剂及脑细胞活化剂,治疗3天,患
Female, 79 years old. After activity because of chest tightness, palpitation 2 years. Aggravated 10 days in April 25, 1991 admission. Diagnosis: coronary heart disease, frequent multi-ventricular premature beats. After admission, according to the conventional treatment of coronary heart sore throat, and give lidocaine 50 mg intravenous injection, and intravenous infusion of 1 mg per minute, the total daily dose of 600 mg. Day 2 patients with lethargy, night into a coma, no nausea, vomiting, no fever, no convulsions. Physical examination: blood pressure 18/11 kPa. Deep coma, normal breathing, bilateral pupil diameter of 3 mm, sensitive to light reflection, neck non-resistance, normal lungs, heart rate> 76 beats / min, smell and more frequent premature beats, heart no noise, Kirschner Sign, Clint’s sign were negative, neuropathic reflex did not lead. ECG shows: frequent premature ventricular contractions, multi-lead T he flat, ST segment depression. A number of cerebrospinal fluid and other laboratory tests showed no abnormalities. So coma reason to be investigated with central nervous system stimulants and brain cell activators, treatment for 3 days, suffering from