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临床资料:患者,男,72岁,退休麻醉师,因肺癌晚期胸痛顿服美施康定片(吗啡缓释片)400 mg,同时自己静脉点滴5%葡萄糖500 ml+杜冷丁针剂100 mg,并打开煤气阀想结束自己的生命,1 h 后被家人发现,15 min 后送来急诊室。既往有下壁心肌梗死、肺癌纵隔转移等病史。体检:神志不清,T 36℃,P 120次/min,BP 120/60 mm Hg,恶液质,深昏迷,全身皮肤及黏膜发绀,瞳孔直径1.0 mm,球结膜水肿,对光反射消失,项强2指,气管偏斜向右,颈静脉无充盈,双肺呼吸音粗,可闻及痰鸣音,右中下肺可闻及管状呼吸音,心浊音界向左下扩大,心率120次/min,律齐,可闻及3/6吹风样杂音,右上腹可见15 cm 斜形手术
Clinical data: Patient, male, 72 years old, retired anesthetist, with 400 mg of midazolam tablets (morphine sustained-release tablets) due to advanced chest pain in the advanced stage of lung cancer and intravenous drip of 5% dextrose 500 ml and pethidine 100 mg intravenously Gas valve to end their own lives, 1 h after the discovery of their families, 15 min after the emergency room. Past history of inferior wall myocardial infarction, lung cancer mediastinal metastasis. Physical examination: unconsciousness, T 36 ° C, P 120 / min, BP 120/60 mm Hg, cachexia, deep coma, systemic skin and mucosal cyanosis, pupil diameter 1.0 mm, conjunctival edema, disappearance of light reflex, Xiangqiang 2 refers to the trachea skewed to the right, no filling of the jugular vein, lung breath sounds thick, can be heard and phlegm, right and middle and lower lung can smell tubular breath sounds, heart and voiced sound sector to the lower left, heart rate 120 / min, law Qi, can be heard and 3/6 hair style noise, the right upper abdomen can be seen 15 cm oblique surgery