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患者,女,66岁。因咳嗽,咳痰喘30余年,心悸气短2年,恶心呕吐伴昏睡不醒3天入院。入院前10天曾在某院住院治疗。每天静脉输入5%葡萄糖500ml加入红霉素0.9g,10%葡萄糖250ml加入氨茶碱0.25g,连续应用9天。病人由入院时能自行步入病房逐渐加重呈昏睡状态,并伴有语言混乱,恶心呕吐,二便失禁。既往患肺结核已愈。无肾上腺皮质,脑垂体及甲状腺疾病。查体:Bp20/10.8kPa,嗜睡状,面部及全身皮肤弹性良好,口唇中度紫绀,双肺散在喘鸣音,双肺底散在中小水泡音。心率104次/分,律齐。肝脾不大,双下肢无浮肿。入院时血气分析:pH7.5,PaCO_2,6kPa,PaO_2 3.5kPa,HCO_3~- 41.7
Patient, female, 66 years old. Due to cough, cough and asthma more than 30 years, shortness of breath palpitations 2 years, nausea and vomiting with sleep 3 days admitted to hospital. 10 days before admission hospitalized in a hospital. 5% daily intravenous infusion of glucose 500ml erythromycin 0.9g, 250ml of 10% glucose aminophylline 0.25g, continuous application of 9 days. Patients admitted to the ward by themselves into the ward gradually aggravated state of lethargy, and accompanied by language disorders, nausea and vomiting, second incontinence. Previously suffering from tuberculosis has been more. No adrenal cortex, pituitary and thyroid disease. Physical examination: Bp20 / 10.8kPa, drowsiness, facial and body skin elasticity is good, moderate cyanosis lips, lungs scattered wheezing, lungs scattered in the middle and small blisters sound. Heart rate 104 beats / min, law Qi. Liver and spleen is not large, no swelling of both lower extremities. Admission blood gas analysis: pH7.5, PaCO_2, 6kPa, PaO_2 3.5kPa, HCO_3 ~ - 41.7