病例男,28岁,因左胸部、左下肢高压电击伤后5h 于1994年9月1日入院。查体意识清楚,气管右偏,左胸有约4％烧伤,创面基底苍白,可见3处电击伤孔直径约0.5～0.8cm,其中第5肋左锁骨中线处电击伤孔随呼吸运动时有气体进出,左第5肋骨可见骨折征。左肺叩诊呈鼓音,左下肺呼吸音消失;心界不大,心率90次/分,律齐;左下肢烧伤创面约6％。创面基底红白相间。实验室检查:白细胞12.2×10~9/L,中性0.91,淋巴0.08;血红蛋白156g/L,血电解质、肾功及肝功均正常,心肌酶谱肌酸磷酸激酶3014U/L,同工酶33.54U/L。胸片示:左侧气胸,左肺压缩约70％,左肋膈角变钝;心电图示:窦性心律不齐,前间壁心肌损伤。入院诊断:①躯干,左下肢电击伤10％Ⅱ度至Ⅲ度;②左开放性血气胸;③左第5肋骨骨折;④心肌损伤。入院后补液,抗 Male, 28 years old, was admitted to hospital on September 1, 1994, 5 hours after the high-voltage electric shock on the left chest and left leg. A clear physical examination, right tracheal deviation, left chest about 4% burn, the wound surface pale, visible three electric shock injury hole diameter of about 0.5 ~ 0.8cm, including the fifth rib left clavicular midline shock injury hole with respiratory movement Gas into and out of the first five ribs visible fracture signs. Pulmonary left percussion was drum sound, left lower lung breath sounds disappear; heart is not big, heart rate 90 beats / min, law Qi; left lower extremity burn wound about 6%. Wound base red and white. Laboratory tests: white blood cells 12.2 × 10 ~ 9 / L, neutral 0.91, lymphatic 0.08; hemoglobin 156g / L, blood electrolytes, renal function and liver function were normal myocardial enzymes creatine phosphokinase 3014U / L, isoenzyme 33.54U / L. Chest X-ray showed: the left pneumothorax, left lung compression of about 70%, left costal diaphragm angle dull; ECG shows: sinus arrhythmia, anterior myocardial injury. Admission diagnosis: ① torso, left lower extremity electric injury 10% Ⅱ degree to Ⅲ degree; ② left open hemothorax; ③ left 5 rib fractures; ④ myocardial injury. After admission fluid, anti