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思者,男性,66岁。诊断为冠心病亚急性前间壁心肌梗塞。入院第4天再发前间壁心肌梗塞。距上次心肌梗塞恰及1个月,于上午8时10分突然被发现口内溢出大量呕吐物、抽搐、意识丧失、四肢冰冷、大汗淋漓,无心跳、脉搏,呼吸浅慢继而停止。即清除口腔内呕吐物,给氧,胸外按压,人工呼吸。2分钟内进行心电监测,无心电波形,呈一直线。4分钟内建立双条静脉通道,其一推入异丙肾上腺素(异丙)、阿托品各1mg,克分子乳酸钠60ml,另一滴注低分子右旋糖酐(低右)、维脑路通、多巴胺8~10ug/kg.min,8时20分再次推入乳酸钠60ml,继以ATP、辅酶A、细胞色素C滴注。8时30分瞳孔进行性散大。心电图示窦性静止,坚持胸外按压、人工呼吸,再次推入异丙、阿托品各1mg,10%葡
Sizhu, male, 66 years old. Diagnosis of coronary heart disease subacute anterior myocardial infarction. Day 4 admitted to the anterior myocardial infarction. Myocardial infarction from the last just 1 month, at 8:10 am was suddenly found in the mouth spilled a large number of vomit, convulsions, loss of consciousness, limbs cold, sweating, no heartbeat, pulse, breathing slow and then stop. That the removal of oral vomit, oxygen, chest compression, artificial respiration. 2 minutes ECG monitoring, no ECG waveform, was a straight line. Within 4 minutes to establish double venous access, the first push isoproterenol (isopropyl), atropine each 1mg, sodium lactate 60ml, another infusion of low molecular weight dextran (low right), Venoruton, dopamine 8 ~ 10ug / kg.min, 8:20 again pushed 60ml sodium lactate, followed by ATP, coenzyme A, cytochrome C infusion. 8:30 pupil progressive bulk. Electrocardiogram sinus static, insist on chest compressions, artificial respiration, once again into the isoprenaline, atropine each 1mg, 10% of Portuguese