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朱××,女,36岁。 主诉:右后下牙痛二天,要求拔牙。 既往病史:患者患红斑狼疮已九年,服用糖皮质激素每日5～10mg已三年;右下后牙痛,反复发作已半年。 检查:6深龋残冠,叩痛(++),松动(-),牙周软组织稍红肿,右面颊部软组织轻度浮肿,右颌下淋巴结肿大,有压痛。 治疗经过:术前给麦迪霉索200mg口服,一日四次;强的松20mg晨服,隔日一次;维生素C和B族维生素等药物。三天后,局部炎症被控制,上午十时,在常规局麻下拔牙,因残冠碎裂,经颊侧去骨少许,取出断根,手术约20分钟,正在上纱条止血时,患者突感全身不适,继而大汗淋漓,表情淡漠,面色苍白,脉搏细弱,四肢厥冷。立即取平卧
Zhu × ×, female, 36 years old. Chief Complaint: Toothache right back two days, requesting tooth extraction. Past medical history: patients with lupus has been nine years, taking glucocorticoids daily 5 ~ 10mg has been three years; right lower back toothache, recurrent has been six months. Check: 6 deep caries crown, percussion pain (++), loose (-), periodontal soft tissue slightly swollen, right soft tissue buccal swelling, submandibular lymph nodes, tenderness. After treatment: Premedication to MDT cable 200mg orally, four times a day; prednisone 20mg morning service every other day; vitamin C and B vitamins and other drugs. Three days later, the local inflammation was controlled. Ten o’clock in the morning, under normal local anesthesia, tooth extraction, due to broken crown, a little bony buccal removal of the root, the operation for about 20 minutes, the gauze hemostasis, the patient suddenly felt General malaise, followed by sweating, indifferent expression, pale, weak pulse, extremities Jueleng. Take supine immediately