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患者,男,63岁,干部。因肝硬化腹水,于1996年6月入院。给予保肝利尿,抗炎支持疗法,于7月3日12:30输入10％葡萄糖500ml、三磷酸腺苷40mg、辅酶A100U、10％氯化钾10ml,滴速70滴/分。液体输进100ml时,病人自觉喉痒、胸闷、呼吸不畅。初考虑为腹水所致,嘱患者取半坐卧位,给予吸氧,减慢输液速度。5分钟后,病人张口呼吸伴哮喘,面部及口唇紫绀,大汗,血压9/7kPa,呼吸28次/分,心率120次/分。肺部听诊:双肺满布噪音。因辅酶A和10％氯化钾无过敏副作用,故诊为三磷酸腺苷致过敏性哮喘。立即抢救:加大吸氧流量,肌肉注射地塞米松5mg,同时停止输入三磷酸腺苷组液体,给50％葡萄糖40ml、氨茶碱0.5g静脉注射,口服息斯敏1片。15分钟后患者呼吸困难得以改善,心率减慢,面部及口唇无明显紫绀,血压回升,继续给常规液10％葡萄糖250ml、氨苄青霉素5.0g静脉滴注,4小时后哮喘症状完全消失。
Patient, male, 63 years old, cadre. Due to liver cirrhosis, admitted in June 1996. Give liver protection diuretic, anti-inflammatory support therapy, at 12:30 on July 3 input 10% glucose 500ml, adenosine triphosphate 40mg, coenzyme A100U, 10% potassium chloride 10ml, drip rate 70 drops / min. Liquid into the 100ml, the patient conscious throat itch, chest tightness, poor breathing. Initially considered as caused by ascites, Zhu Huanzhe take semi-sedentary position, given oxygen, slow infusion speed. After 5 minutes, the patient mouth breathing with asthma, facial and lip cyanosis, sweating, blood pressure 9 / 7kPa, breathing 28 beats / min, heart rate 120 beats / min. Lung auscultation: lungs full of noise. Due to coenzyme A and 10% potassium chloride no allergic side effects, so diagnosed as adenosine triphosphate-induced allergic asthma. Immediate rescue: increase oxygen flow, intramuscular injection of dexamethasone 5mg, at the same time stop the input of adenosine triphosphate group liquid to 50% glucose 40ml, 0.5g aminophylline intravenously, oral Astemizole 1 tablets. 15 minutes later, patients with dyspnea can be improved, heart rate slowed, no cyanosis of the face and lips, blood pressure rise, continue to conventional liquid 250ml of 10% glucose, ampicillin 5.0g intravenous infusion, 4 hours after the asthma symptoms disappear completely.