病历摘要例1 患者,男性,54岁。有慢性克山病史,反复心悸、气短10年余,近5天来不能平卧伴胸闷、全身浮肿于1990年8月15日入院。体检:Bp8.0/5.3,半卧位,颜面浮肿,口唇发绀,颈静脉怒张,双肺可闻散在干、湿罗音。心率82次/分,律绝对不整,心尖部可闻Ⅱ级收缩期吹风样杂音,肝大剑下3.0cm,双下肢浮肿。实验室检查:Na~+142,K~+3.3,Ca~++2.5。心电图报告心房纤颤,多源性室早。给予补钾、升压、强心、利尿、抗心律失常治疗。入院第2天突然抽搐,双眼凝视,四肢强直。心率176次/分,心音微弱。心电图呈室速,在心电监测下立即给予25％葡萄糖20ml加利多卡因100mg静脉推注并持续滴入,连续静脉推注利多卡因3次(300mg)无效,故停用利多卡因,改用25％葡萄糖20ml加25％硫酸镁10ml静脉推注,每分钟150mg,当硫酸镁注射800mg后室速 Case Summary 1 patient, male, 54 years old. A history of chronic Keshan, repeated heart palpitations, shortness of breath more than 10 years, the past 5 days can not be supine with chest tightness, body edema admitted on August 15, 1990. Physical examination: Bp8.0 / 5.3, semi-recumbent position, facial edema, cyanotic lips, jugular vein engorgement, lungs can be scattered in the dry, wet rales. Heart rate 82 beats / min, the law is absolutely not whole, the apex can smell Ⅱ systolic hair-like murmur, liver big sword 3.0cm, lower extremity edema. Laboratory tests: Na ~ +142, K ~ +3.3, Ca ~ + +2.5. ECG reports atrial fibrillation, multi-ventricular premature. Given potassium, boost, cardiac, diuretic, anti-arrhythmia treatment. Admitted to the first two days of sudden convulsions, his eyes staring, limbs straight. Heart rate 176 beats / min, weak heart sounds. Electrocardiogram showed ventricular tachycardia immediately under ECG monitoring given 25% glucose 20mg lidocaine 100mg intravenous infusion and continued infusion, continuous intravenous injection of lidocaine 3 times (300mg) is invalid, so disable lidocaine, change With 25% glucose 20ml plus 25% magnesium sulfate 10ml intravenous injection, 150mg per minute, when magnesium sulfate injection 800mg ventricular tachycardia