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患者,女,38岁.因月经过多伴痛经5年,于1991年8月19日以“子宫腺肌症”收住院.曾有肝炎史.体检:生命体征正常,肥胖体型,颈静脉无充盈,心界无扩大,心率88次/分,律齐,无杂音.子宫如鸡蛋大小,质硬,活动度差,有压痛.心电图示偶发室早,二级梯试验、肝功能及血电解质检查均正常.8月22日上午9时在连续硬膜外麻醉下行子宫全切,刚切开腹膜,患者突现呼吸困难,口唇紫钳,血压10.7/6.7kPa,双肺底水泡音,心率80次/分,律齐.停止手术,按急性左心衰竭处理:面罩加压给氧,使用强心、利尿、血管活性药物等,心率逐渐减慢.用阿托品、异丙肾上腺素及食管调搏等治疗无效,心跳停止而亡.尸体解剖病理诊断:①脂肪心(脂肪层已占据心壁厚度4/5)伴小灶状心肌纤维化;②急性肺水肿、肺出血;③肝肾肠
Patient, female, 38 years old due to menorrhagia with dysmenorrhea for 5 years, August 19, 1991 to “adenomyosis” admitted to hospital. Have had a history of hepatitis. Physical examination: vital signs normal, obese body, jugular vein Filling, no expansion of the heart, the heart rate of 88 beats / min, law Qi, no noise. Uterus, such as the size of eggs, hard, poor activity, tenderness.Electrocardiogram showed premature ventricular premature, second ladder test, liver function and blood electrolyte The examinations were normal at 9:00 on the August 22 in continuous uterine epidural anesthesia underwent total hysterectomy, just open the peritoneum, the patient suddenly showed dyspnea, the mouth red clamp, blood pressure 10.7 / 6.7kPa, the end of the lungs blisters sound, heart rate 80 Times / minutes, law Qi. Stop surgery, according to the treatment of acute left heart failure: pressure mask to oxygen, the use of cardiac, diuretic, vasoactive drugs, heart rate gradually slowed with atropine, isoproterenol and esophageal pacing Such as treatment is invalid, the heartbeat stopped and died.The autopsy pathological diagnosis: ①Fatty heart (fat layer has occupied the wall thickness of 4/5) with small focal myocardial fibrosis; ② acute pulmonary edema, pulmonary hemorrhage; ③ liver and kidney