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我院近期有3例重症贫血的急性白血病患者,在输血时诱发急性左心衰致死。现报道如下。例1 邓某,男,30岁.因进行性头昏、心慌、乏力、低热四月就诊.血液学检查确诊为M_2型急性粒细胞性白血病.于1987年7月24日入院。入院时呈重度贫血貌、心界稍向左扩大,心率92次,律齐,心尖区Ⅲ级SM,双肺(一)。入院后开始HOAP方案化疗。化疗结束后,于8月19日输全血300ml,输血前查Hb36g/L,RBC1.12×10~(12)/L,输血当日的输液总量为1800ml,晶体液量为1500ml.输血过程中患者突感呼吸困难、气急、不能平卧、大汗淋漓、继而咯粉红色泡沫痰、心率120次、双肺湿啰音,立即吸氧,静注西地蓝,速尿等治疗,心衰始
In our hospital, there are 3 cases of acute leukemia patients with severe anemia recently, causing acute left heart failure when transfusion. Report as follows now. Example 1 Dengmou, male, 30 years old due to progressive dizziness, palpitation, fatigue, low fever treatment. Hematology confirmed M_ (2) acute myeloid leukemia in July 24, 1987 admission. Admitted to a severe anemia appearance, the heart slightly expanded to the left, heart rate 92, law Qi, apical area Ⅲ SM, lung (a). HOAP chemotherapy after admission. At the end of chemotherapy, 300 ml of whole blood was transfused on August 19, Hb 36 g / L and RBC 1.12 × 10 12 / L before transfusion, the total amount of transfusion on the day of transfusion was 1800 ml, and the amount of crystal fluid was 1500 ml. In patients with sudden sensory dyspnea, shortness of breath, can not lie down, sweating, then slightly pink foam sputum, heart rate 120 times, lung wet rales, immediately oxygen, intravenous injection of blue, furosemide and other treatment, heart Decline