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一、临床资料320例均为我院急诊科近年来门诊留观或收入急诊病房患者,其中男206人,女114人,年龄最大72岁,最小17岁,平均年龄51岁,治疗最短时间3天,最长62天.各种疾病为:酒精中毒178例,安眠药中毒88例,休克14例,昏迷10例,肺性脑病8例,吗啡中毒9例,二羟艾托菲过量8例,海洛因中毒5例.二、典型病例例1:男性,个体户,32岁,生气后自饮白酒7ml~800ml,家人发现时不省人事,口流涎,两便失禁,抬入急诊科.查体:血压9/Okpa,全身湿冷,瞳孔对光反射消失,心音低弱,两肺散在干湿罗音.立即葡萄糖200ml加纳洛酮0.8mg静推,30min后瞳孔有对光反射,仍是昏迷症状,又间断从输液小壶加入纳洛酮0.4mg3次,病人清醒,12h后能下地,3天后痊愈出院.例2:男性,66岁,突然心前区剧痛,大汗淋漓2h.高血压病史10余年.血压测不清,口唇紫绀,两肺散在干鸣,心音低弱,有早搏,心电图急性广泛前壁心梗,心源性休克.立即镇痛,采用多种措施,并用多巴胺升压1h后胸痛缓解,血压仍很低,从小壶间断给纳洛酮0.4mg2次,2h后血压回升,病情趋向平稳.例3:女性,76岁,肺心病10余年.一次伤感后,突然出现喘憋,呼吸困难昏迷.诊为“肺性脑病”.查体:血压0,呼吸:28次/min.颜面紫绀,颈V怒张,两肺满布干湿罗音,心音听不清.立即抗休克、抗炎,综合治疗1天,症状不缓解,仍处于?
First, the clinical data of 320 cases of our hospital emergency department in recent years, outpatient or income emergency ward patients, of which 206 were males and 114 females, the oldest 72 years old, the youngest 17 years old, mean age 51 years, the shortest treatment time 3 Days, the longest 62 days.All diseases: alcohol poisoning in 178 cases, sleep poisoning in 88 cases, shock in 14 cases, coma in 10 cases, pulmonary encephalopathy in 8 cases, morphine poisoning in 9 cases, dihydroxyetothelin overdose in 8 cases, Heroin poisoning in 5. Second, the typical cases Example 1: male, self-employed, 32 years old, angry after drinking liquor 7ml ~ 800ml, family members found unconscious, drooling, incontinence, into the emergency department. Blood pressure 9 / Okpa, body wet and cold, the pupil light reflex disappeared, weak heart sounds, both lungs scattered in the wet and dry rales. Immediately glucose 200mg ganaloxone 0.8mg static push, 30min after the pupil light reflex, or coma, Intermittent infusion of small pot from adding 0.4mg naloxone 3 times, the patient awake, 12h after the ground, 3 days after the discharge was cured .Example 2: Male, 66 years old, sudden acute precordial pain, sweating 2h .Hypertensive history More than 10 years.Ultrasonic pressure test, cyanosis of the lips, lungs scattered in the dry Ming, weak heartbeat, premature beat, acute anterior ECG extensive anterior myocardial infarction, cardiogenic shock. Analgesia, using a variety of measures, and chest pain relief after 1h with dopamine booster, blood pressure is still very low, from the pot intermittent to naloxone 0.4mg2 times, 2h after blood pressure rise, the condition tends to be smooth.Example 3: Female, 76 years old, Pulmonary heart disease more than 10 years .A sad, suddenly appeared wheezing, breathing difficulties coma .Considered as “pulmonary encephalopathy.” Physical examination: blood pressure 0, breathing: 28 beats / min. Facial cyanosis, neck V anger, Cloth wet rales, heart sounds can not hear immediately anti-shock, anti-inflammatory, comprehensive treatment of 1 day, the symptoms do not ease, still in?