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男,43岁。因患扩张型心肌病、充血性心力衰竭、偶发室性早搏住院。经治疗,心衰控制。入院第15天中餐后突然神志不清,跌倒于床上。体查:意识丧失,脉搏不能扪及,呼吸18次,血压0,双侧瞳孔直径4.5mm,光反射消失,唇紫绀,双肺呼吸音弱、心音消失。立即予胸外心脏按压,静脉推注利多卡因100mg,心电监护示波为室颤,立行电击除颤转为室性心动过速,继用利多卡因疗效不佳行第2次电转复,转为短阵性室性心动过速。加用普鲁卡因酰胺及慢心律持续12小时无明显改善。此时查血
Male, 43 years old. Due to dilated cardiomyopathy, congestive heart failure, occasional ventricular premature be admitted. After treatment, heart failure control. 15 days after admission, suddenly unconscious after lunch, fell to bed. Physical examination: loss of consciousness, pulse can not palpable, breathing 18 times, blood pressure 0, bilateral pupil diameter 4.5mm, light reflex disappeared, lip cyanosis, lung breath sounds weak, heart sound disappeared. Immediate chest compression, intravenous lidocaine 100mg, ECG monitoring of ventricular fibrillation, standing shock defibrillation into ventricular tachycardia, following the poor efficacy of lidocaine row 2 electric re- , Into a short burst of ventricular tachycardia. With procainamide and slow heart rate continued for 12 hours without significant improvement. Check blood at this time