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患者,女,24岁。因气喘2天,加重持续1天入院。幼儿时有支气管哮喘病史,近20年来未曾发作。2天前;患者因受凉后出现气喘,伴轻度咳嗽,咳痰。1天前气喘突然加重,不能平卧,持续不能缓解,急去附近医院,经给予吸氧、糖皮质激素、氨茶碱、抗生素、抗过敏药物等治疗未见好转,随即来河北医科大学第二医院急诊室。患者面色苍白,口唇指甲紫绀,端坐呼吸,有窒息感,两肺呼吸音弱,可闻及少量哮鸣音,心率110次/min,律齐,无杂音,腹软,肝脾未触及。立即给予吸氧,静点氨茶碱未见好转,口唇指甲紫绀加重,呈点头呼吸,又给洛贝林、喘定各1支,但症状并无改善,旋即发现意识丧失,呼吸心跳停止,大动脉搏动消失,心音听不到,无脑膜刺激征和病理反射,为重症支气管哮喘持续状态导致呼吸心跳停止。立即给予胸外心脏按压、口对口人工呼吸,高流量吸氧,并先后静脉注射肾上腺素、阿托品各1mg.克拉明、洛贝林各1支,约4分钟后心
Patient, female, 24 years old. 2 days due to asthma, aggravating 1 day admission. Childhood bronchial asthma history, no seizures in the past 20 years. 2 days ago; patients with asthma due to cold, with mild cough, sputum. Suddenly increased asthma 1 day ago, can not supine, sustained can not be alleviated, anxious to go to nearby hospitals, given to oxygen, glucocorticoids, aminophylline, antibiotics, anti-allergy drugs and other treatment did not improve, and then to Hebei Medical University Second hospital emergency room. Patient pale, lips and nails cyanosis, sitting breathing, asphyxia, lung breath sounds weak, can be heard and a small amount of wheezing, heart rate 110 beats / min, law Qi, no noise, abdominal soft, liver and spleen not touched. Immediately give oxygen, point aminophylline did not improve, cyanotic lips nails aggravated, nodded his breath, gave Lobelin, wheezing each one, but the symptoms did not improve, and immediately found that loss of consciousness, respiratory arrest stopped, Aortic pulsation disappeared, heart sound can not hear, no meningeal irritation and pathological reflex, severe bronchial asthma caused by the continuous state of respiratory arrest. Immediately give chest cardiac pressure, mouth mouth artificial respiration, high-flow oxygen, and intravenous epinephrine, atropine each 1mg.Clamin, Lobelin each one, about 4 minutes after the heart