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例1:男,64岁。因心悸、气短15年,加重伴全身水肿10天入院。查体:颜面水肿,口唇中度紫绀,颈静脉怒张,双肺底闻及干湿性罗音。心律不齐,闻及期前收缩8～10次/分,心率100次/分。肝右肋下4.Ocm,剑突下5.Ocm,质韧,腹水征阳性。双下肢凹陷性水肿。经胸部X线拍片、B超、心电图、心向量图检查,诊为充血性心肌病,心力衰竭,频发室性期前收缩。先后给予强心、利尿、扩血管药物及抗感染等治疗,病情好转。入院第3天患者头晕、胸闷加重,给予利多卡因100mg,5分钟静脉注毕,2分钟后室性期前收缩消失,出现,度房室传导阻滞,30秒后患者突然意识丧失,全身抽搐,心电示心脏停搏。立即叩击心脏,心脏按压,吸氧,阿托品lmg,地塞米松10mg,50％葡萄糖20ml加多巴胺20mg静脉推注,异丙基肾上腺素2mg加入10％葡萄糖500ml静脉点滴,5分钟后神志转清,血压10/8kPa,住院16天好转出院。
Example 1: Male, 64 years old. Due to heart palpitations, shortness of breath 15 years, aggravated with systemic edema 10 days admitted. Examination: facial edema, moderate cyanosis lips, jugular vein engorgement, both at the end of the lung smell and wet and dry rales. Arrhythmia, smell and period before the contraction of 8 to 10 beats / min, heart rate 100 beats / min. Right hepatic ribs 4.Ocm, xiphoid 5.Ocm, quality toughness, ascites sign positive. Depression of both lower extremity edema. The chest X-ray film, B ultrasound, ECG, cardiac vector chart examination, diagnosed with congestive cardiomyopathy, heart failure, frequent ventricular contraction. Has given cardiac, diuretic, vasodilator drugs and anti-infection treatment, condition improved. Patients dizziness, chest tightness increased on day 3 of admission, given lidocaine 100mg, intravenous infusion of 5 minutes, 2 minutes later ventricular contraction disappeared, a degree of atrioventricular block, the patient suddenly lost consciousness after 30 seconds, the whole body Convulsions, ECG showed cardiac arrest. Immediately tap the heart, heart pressure, oxygen, atropine lmg, dexamethasone 10mg, 50% glucose 20ml dopamine 20mg intravenous injection, isoproterenol 2mg added 10% glucose 500ml intravenous drip, 5 minutes after conscious mind clear , Blood pressure 10 / 8kPa, hospital discharge improved 16 days.