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1 病例报告 患者男,61岁。因反复咳嗽、咳痰15年,加重伴大咯血2天,于1996年2月22日入院。诊断:①浸润型肺结核(上、中、下)/(上、中、下)涂(+)进展期并咯血;②慢支炎、肺气肿、肺心病。经相应处理,病情稍有好转。25日晚10时进流质食物引起呛咳,咯血约100ml,迅即出现呼吸困难,发绀,阵阵剧咳并咳出大量红色泡沫痰,双肺满布大、中水泡音,心率156次/min,第一心音低钝,心尖区可闻及舒张期奔马律。继而呼吸缓慢(5次/min),呈抬肩式鱼口样呼吸,意识模糊,躁动不安。此时患者是因咯血致窒息诱发急性左心衰、呼衰和肺性脑病,即出现了多脏器功能衰竭。 抢救经过:首先给患者取仰卧位,头向床沿,垫
1 case report Patient male, 61 years old. Due to repeated cough, sputum 15 years, aggravated with massive hemoptysis for 2 days, on February 22, 1996 admission. Diagnosis: ① infiltrative pulmonary tuberculosis (upper, middle and lower) / (upper, middle and lower) coated (+) advanced and hemoptysis; ② chronic bronchitis, emphysema, pulmonary heart disease. After appropriate treatment, the condition improved slightly. 25 at 10 pm into the liquid food caused by cough, hemoptysis about 100ml, immediately appeared dyspnea, cyanosis, bursts of cough and cough up a large number of red foam sputum, lungs covered with large, water bubble, heart rate 156 beats / min , The first heart sound low blunt, apex area can be heard and diastolic gallop. Then slow breathing (5 times / min), was raised shoulder-type fish-mouth breathing, confusion, restlessness. At this point the patient is induced by hemoptysis asphyxia induced acute left heart failure, respiratory failure and pulmonary encephalopathy, that is, multiple organ failure occurred. Rescue after: first to supine patients, head to the bed, pad