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患者61岁,患慢性风湿性心瓣膜病、二尖瓣狭窄30余年,14年前作二尖瓣分离术,后出现持续性心房颤动和Ⅱ°心力衰竭。1982年以来,常在入睡后半小时内发作阿斯综合征,发作时大叫一声,继之意识丧失,四肢抽搐,大小便失禁,呼吸暂停,脉搏心音消失。发作频繁时每日达10～20次,现已发作119次,每次均经家庭病床枪救好转。好转后表现烦躁不安,痉挛性咳喘,端坐呼吸约半小时后意识恢复。心电图示:快速房颤心律(平均室率120～180次/分)Ⅱ°,高度房室传导阻滞(发作后30分钟左右描记)。抢救措施如下: 一.畅通气道,立即去枕仰卧; 二.鼻导管给氧,同时用去泡沫剂(50％酒精置于氧气筒的湿化瓶内);
The patient, 61 years old, had chronic rheumatic valvular disease, mitral stenosis more than 30 years, mitral valve severing 14 years earlier, persistent atrial fibrillation and Ⅱ ° heart failure. Since 1982, asymptomatic onset within half an hour after onset of asymptomatic onset, shouting, followed by loss of consciousness, limbs convulsions, incontinence, apnea, pulse heart sound disappeared. Seizures frequently daily up to 10 to 20 times, now has seizures 119 times, each time by the family hospital bed better. After the performance of irritability, spasmodic cough, sit back and breathing about half an hour after the recovery of consciousness. ECG shows: rapid atrial fibrillation (average room rate of 120 to 180 beats / min) Ⅱ °, atrioventricular block (30 minutes after the onset of trauma). Rescue measures are as follows: 1. smooth airway, immediately to pillow reclining; two nasal catheter oxygen, at the same time to the foam (50% alcohol placed in the oxygen cylinder wet bottle);