论文部分内容阅读
李××,男,47岁。1978年8月23日14时左右不慎跌入井中约3分钟,经当地卫生院急救后转送我院时为当天16时30分。入院检查深昏迷,伴强直性抽搐,明显萦绀。呼吸浅速(26次/分),血压150/100毫米汞柱,脉率104～150次/分。眼结膜充血水肿,口、鼻流出大量粉红色泡沫状液。两肺满布湿罗音,心电图示心肌缺血,血红蛋白尿,血非蛋白氮41毫克％,二氧化碳结合力43容积％,血钾及白细胞计数正常。既往有癫癎史。入院后即给氧吸入、呼吸兴奋剂、激素、碱性药物、脱水剂、西地兰、能量合剂及抗菌素等。因患者有抽搐及支气管痉挛,经气管插管进行人工呼吸时发生困难,乃于18时15分应用肌松剂筒箭毒7.5毫克静脉注射,以后再用定容型人工呼吸器进行间断正压控制呼吸(IPPV),潮气量800毫升,每分钟12次。当时血压一度下降至60/50
Li × ×, male, 47 years old. At about 23 o’clock on the August 23, 1978 accidentally fell into the well for about 3 minutes, after the emergency by the local hospital forwarded to our hospital when 16:30 the same day. Admission examination deep coma, with tetanic convulsions, obviously cyanosis. Breathing shallow speed (26 beats / min), blood pressure 150/100 mm Hg, pulse rate of 104 to 150 beats / min. Conjunctival congestion and edema, mouth, nose, a large number of pink foam liquid. Two lungs full of moist rales, ECG showed myocardial ischemia, hemoglobinuria, non-protein nitrogen 41 mg%, carbon dioxide binding capacity of 43% by volume, serum potassium and white blood cell count was normal. Past history of epilepsy. After admission to oxygen inhalation, respiratory stimulants, hormones, alkaline drugs, dehydrating agents, cedilanid, energy mixture and antibiotics. Due to convulsions and bronchospasm in patients with endotracheal intubation for artificial respiration difficulties, but at 18:15 using muscle relaxant tuberculin 7.5 mg intravenously, and then constant volume respirator intermittent positive pressure Controlled breathing (IPPV), tidal volume of 800 ml, 12 times per minute. Blood pressure dropped to 60/50 at that time