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患者:男,62岁。高血压十余年,血压持续在170~180/110~120。8年前患脑血栓。6日前因头痛、视物模糊、恶心、呕吐于1987年2月24日留观察。经一般降压治疗,降压不明显,头痛加重,渐嗜睡,6日后入院。当时检查:脱水貌、嗜睡、回答切题、呼吸平稳、心率92次/分,血压190/140,未引出病理反射,ECG查室性心律,左室肥厚。诊断为高血压病Ⅲ期,高血压脑病。入院后血压190/140,心率80/分。给以硝普钠25mg加入10%葡萄糖250ml,静脉滴注(滴注前已将药溶于液体内)。在固定、调整滴数约3-5分,患者突然两眼上吊,抽搐,呼吸加深,心音消失。ECG呈一直线,无血压。立即停药并给以胸外心脏按摩、吸氧、多巴胺40mg加入10%葡萄糖500ml静脉滴注、肾上腺素1mg肌注等抢救约5分后,心跳恢复,神
Patient: Male, 62 years old. More than ten years of hypertension, blood pressure continued at 170 ~ 180/110 ~ 120. 8 years ago with cerebral thrombosis. 6 days ago due to headaches, blurred vision, nausea, vomiting in February 24, 1987 to observe. After the general antihypertensive treatment, antihypertensive is not obvious, headache increased, gradually lethargy, admitted to hospital after 6 days. At that time check: dehydration appearance, lethargy, answer cut, breathing steady, heart rate 92 beats / min, blood pressure 190/140, did not lead to pathological reflex, ECG check ventricular rhythm, left ventricular hypertrophy. Diagnosis of hypertension stage Ⅲ, hypertensive encephalopathy. After admission blood pressure 190/140, heart rate 80 / min. To sodium nitroprusside 25mg 10% glucose 250ml, intravenous drip (the drug has been dissolved in the liquid before drip). In the fixed, adjust the drop about 3-5 minutes, the patient suddenly two eyes hanging, twitching, breathing deepened, heart sound disappeared. ECG was straight, no blood pressure. Immediate withdrawal and give chest heart massage, oxygen, dopamine 40mg 10% glucose 500ml intravenous infusion of epinephrine 1mg intramuscular injection and other rescue about 5 minutes after the recovery of the heart, God