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1.
2例女性风湿性心脏病患者静脉滴注胺碘酮出现休克.例1为47岁女性风湿性心脏病患者,给予胺碘酮150 mg加入5%葡萄糖注射液100 ml静脉滴注.输入约70 ml时,患者出现胸闷、烦躁不安,血压下降至59/32 mm Hg,HR 116次/min.停用胺碘酮,静脉注射多巴胺10 mg,20 min后患者血压逐渐恢复至100/70 mm Hg.HR 110次/min.例2为62岁女性风湿性心脏病患者,给予胺碘酮150 mg加入5%葡萄糖注射液100 ml静脉滴注.输注2 min后,患者出现口唇发麻、胸闷、气短、头胀.停用胺碘酮,改用0.9%氯化钠注射液静脉滴注.之后患者症状加重,出现面色苍白,口唇发绀,烦躁不安.血压下降至50/0 mm Hg,HR 140~170次/min.先后静脉注射地塞米松2 mg和多巴胺10 mg,并用多巴胺20 mg加入100 ml 0.9%氯化纳注射液中静脉滴注.20 min后患者血压逐渐恢复至90/50 mm Hg,HR为118~160次/min,症状缓解.  相似文献   

2.
1例17岁女性,因肛裂使用九华痔疮拴治疗.在首次用药后2~3 min,患者突然出现全身瘙痒、嘴唇肿胀,皮肤出现大小不等的风团.立即就诊,给予地塞米松10 mg肌内注射,50%的葡萄糖注射液20 ml+10%葡萄糖酸钙10 ml静脉推注,并给予开塞露20 ml将痔疮栓排出.之后患者出现全身无力,意识模糊.查体:P 108次/min,R 30次./min,BP 70/48 mm Hg.立即肌内注射0.1%肾上腺素0.3 ml和静脉补液.4 h后症状完全消失,P 70次/min,R 18次/min,BP 120/80 mm Hg.患者痊愈出院.  相似文献   

3.
患者男,60岁.因急性出血性脑血管病于2004年8月3日住院.当时查体:体温35.8℃,脉搏84次/min,呼吸19次/min,血压140/90 mm Hg,神志清楚.静脉给5%葡萄糖注射液(本院灭菌制剂室生产)250ml和氨基己酸(常州市第二制药厂生产)6.0 g.当点滴至150 ml时,患者突然出现头晕、乏力、胸闷、大汗淋漓,血压80/50 mm Hg,遂停药,给多巴胺注射液100mg,间羟胺注射液50 mg,维持血压在100~90/80~70 mm Hg,约1 h后,各项生命体征趋于平稳,血压稳定在110/70 mm Hg.  相似文献   

4.
1例43岁男性患者,因脊髓损伤后双下肢痛入院行手术治疗.入院时BP 157/100 mm Hg.术中行麻醉诱导后BP110/70 mm Hg,随后将患者由仰卧变为俯卧,给予头孢曲松2 g入0.9%氯化钠注射液100 ml静脉滴注,几分钟后患者出现血压下降,BP 60/40 mm Hg,HR 100次/min,ECG出现T波倒置.考虑为麻醉后体位性低血压,经处理后情况好转,手术顺利完成.术后生命体征平稳,第2天再次给予头孢曲松静脉滴注,滴入10 ml后患者突然出现全身痒、胸闷、大汗及呼吸困难.BP70/40 mm Hg,HR 130次/min,SpO2 0.80.立即停用头孢曲松,给予抗过敏、扩客及抗休克等治疗,症状逐渐消失,血压平稳.  相似文献   

5.
1例42岁女性患者行右侧甲状腺次全切除术,术前心率80次/min,血压130/80 mm Hg(1 mm Hg=0.133 kPa)。采用利罗合剂(2%利多卡因10 ml+0.894%甲磺酸罗哌卡因10 ml)行双侧颈神经丛阻滞麻醉。10 min后患者胸部出现荨麻疹,心率110次/min,血压155/110 mm Hg,随后腹部与下肢均出现荨麻疹,心率125次/min,血压160/100 mm Hg。即刻给予吸氧,静脉注射地塞米松10 mg,5 min后荨麻疹有所减退。又肌内注射苯海拉明20 mg,5 min后心率95次/min,血压140/90 mm Hg,荨麻疹完全消失。  相似文献   

6.
1例68岁女性糖尿病性视网膜病变患者,为行眼底血管造影检查使用1%荧光素钠注射液5 ml静脉注射行过敏试验.静脉注射后3 min,患者出现呼吸困难,意识不清,BP 40/20 mm Hg,心跳停止1 min.立即给予肌内注射异丙嗪50 mg,地塞米松10 mg,肾上腺素1 mg治疗.后来查体:P 124次/min,BP 147/81 mm Hg,患者处于醒状昏迷.住院175 d后,患者以醒状昏迷出院.  相似文献   

7.
硝酸甘油静脉滴注相关的血压升高   总被引:1,自引:0,他引:1  
1例63岁男性患者,因患心绞痛入院.入院时BP为 130/80 mm Hg.入院后给予患者口服阿司匹林、辛伐他汀和通心络等药物治疗,并给予硝酸甘油10 mg溶入5%葡萄糖250 ml静脉滴注.在第1次滴注开始后半小时患者出现血压升高(150/90 mm Hg)、头痛和胸闷.次日,第2次滴注开始后5 min患者再次出现头痛、胸闷及血压升高(170/100 mm Hg).之后,停用硝酸甘油,其余药物继续使用,患者血压恢复正常.  相似文献   

8.
血必净注射液致过敏反应   总被引:2,自引:0,他引:2  
1例44岁男性患者因自行服用利血平约50片,出现恶心、呕吐、头晕、乏力,送医院急诊。给予血必净注射液50 ml加入0.9%氯化钠注射液250 ml静脉滴注。约5 min后,患者突然出现呼吸急促、大汗、面部潮红、心慌、胸闷、呼吸困难,血压73/50 mm Hg(1 mm Hg=0.133 kPa),心率93次/min,呼吸22次/min。立即停止输液,给予氢化可的松、地塞米松、多巴胺,同时行吸氧及心电监护。30 min后患者病情好转,血压106/76 mm Hg。  相似文献   

9.
1例16岁男性患儿因先天性右眼上睑下垂行新斯的明试验.试验前BP 96/60 mm Hg.给予新斯的明注射液1 mg 肌内注射.14 min后,患者出现胸闷、气促、呼吸困难、四肢抽搐、面色苍白、紫绀、脉搏细弱,BP 60/40 mm Hg.立即给予吸氧、肾上腺素、地塞米松、补液等治疗,35 min后症状消失,血压恢复正常.  相似文献   

10.
患者,男,89岁.患有冠心病、心绞痛、高血压等病史.近1年余服用单硝酸异山梨酯片20mg,每天2次;硝酸异山梨酯片5mg,每天3次.2010年9月2日开始频繁出现心绞痛,有时每天发作3~4次.嘱患者9月8日开始每天早餐后加服硝酸异山梨酯片5mg.9月8日早晨7∶ 00血压126/64mm Hg(1mm Hg=0.133kPa),早餐食用较晚,9∶ 30服用单硝酸异山梨酯片20mg、硝酸异山梨酯片10mg,9∶ 55患者在走路时突坐于地上,患者身边工作人员赶快将患者扶到沙发上坐下,立即叫出诊.10∶ 05家中查体:血压80/40mm Hg,脉搏68次/min,不愿说话,半卧于沙发上,立即给予吸氧.心电图示:窦性心律,不完全性右束支传导阻滞.11∶ 10血压90/56mm Hg,意识清晰,对答正确,11∶ 13患者在搀扶下卧床休息,11∶ 50血压116/64mm Hg,16∶ 30血压130/66mm Hg,脉搏64次/min,精神可,无不适.患者近半年每天9∶ 00~10∶ 00血压116~134/60~68mm Hg.  相似文献   

11.
1例4岁男性患儿因重症肺炎给予头孢哌酮钠舒巴坦钠0.8 g静脉滴注、1次/12 h。治疗第3天,滴注该药约15 min时,患儿出现茶色尿、腹痛、皮肤苍白、四肢发凉,立即停止滴注。实验室检查示红细胞计数1.7×10 12/L(治疗前4.7×10 12/L),血红蛋白67 g/L(治疗前121 g/L),网织红细胞计数0.12,总胆红素54.7 μmol/L,间接胆红素42.4 μmol/L,直接抗人球蛋白试验(Coombs试验)阳性;尿蛋白(++),尿潜血(++),尿胆原(+++),尿红细胞87个/HP。考虑为头孢哌酮钠舒巴坦钠导致的急性溶血,并给予甲泼尼龙静脉滴注及其他对症治疗,抗感染治疗换用注射用阿奇霉素。停用头孢哌酮钠舒巴坦钠第9天,患儿血常规、尿常规恢复正常,直接Coombs试验阴性。  相似文献   

12.
The pharmacokinetics and pharmacodynamics of flestolol, a new short-acting, beta-adrenergic receptor antagonist, were examined in nine healthy subjects after a constant intravenous infusion of 5 micrograms/kg/min for 72 hours. Flestolol blood levels were determined by high-performance liquid chromatography. In all subjects, flestolol blood concentration attained steady state 30 minutes after initiation of infusion. The mean +/- standard deviation steady-state concentration of flestolol was 31.1 +/- 12.0 ng/mL. The elimination half-life averaged 7.2 minutes. The mean +/- standard deviation total body clearance was 181 +/- 66 mL/min/kg. The apparent volume of distribution and the area under the curve averaged 1.89 L/kg and 2.23 micrograms-hr/mL, respectively. Flestolol did not cause any significant change (P greater than .05) in the heart rate or systolic or diastolic blood pressure from the baseline. Flestolol significantly (P less than .05) attenuated the isoproterenol-induced increase in heart rate and systolic blood pressure and decrease in diastolic blood pressure in comparison with baseline. The average maximum reduction in isoproterenol tachycardia was in the range of 63% to 79% during flestolol infusion. There was a rapid recovery from beta blockade after termination of flestolol infusion; the recovery averaged 96% 20 minutes after the infusion was stopped. We conclude that flestolol exhibits a very short half-life and is cleared mainly by extrahepatic routes. It is an effective beta blocker and possesses a short duration of action.  相似文献   

13.
1例48岁男性患者因脑脓肿伴继发性癫痫行左侧颞部占位性病变切除术,术后第1天依次静脉滴注单唾液酸四己糖神经节苷脂钠注射液40 mg、青霉素钠320万U(皮肤试验阴性)。药物滴注完毕后约5 min患者出现躁动、口唇发绀、双肺呼吸音粗,可闻痰鸣音,呼吸频率30~40次/min,心率178次/min,血压80~88/48~60 mm Hg(1 mm Hg=0.133 kPa),血氧饱和度0.60。立即予口咽通气管,吸痰,面罩吸氧,气管插管呼吸机辅助呼吸,静脉滴注多巴胺100 mg、间羟胺40 mg、甲泼尼龙0.5 g,静脉注射去乙酰毛花苷0.2 mg、地塞米松4 mg。2 h后患者心率降至110次/min,呼吸频率降至19次/min,血压升至125~135/70~90 mm Hg,血氧饱和度升至1.00,生命体征趋平稳。怀疑休克与青霉素有关。次日停用青霉素,继续静脉滴注氯化钠注射液100 ml+单唾液酸四己糖神经节苷脂钠40 mg,10 min后患者再次出现躁动、呼吸急促,心率增快至160次/min,血氧饱和度降至0.85,血压降至77/45 mm Hg。立即停止静脉滴注,给予呼吸机辅助呼吸以及升压、降低心率、抗过敏、抗炎等对症治疗。40 min后,患者心率降至110次/min,呼吸频率降至18次/min,血压升至110~145/60~90mmHg,血氧饱和度0.98,生命体征平稳。  相似文献   

14.
OBJECTIVE: Hypotension induced by tricyclic antidepressants is multifactorial. Previous animal experiments suggest a contribution from nitric oxide production. Our study aimed to evaluate the role of nitric oxide in amitriptyline-induced hypotension using N-nitro-L-arginine methyl ester, a nitric oxide synthesis inhibitor, and 3-morpholino sydnonimine, a nitric oxide donor, in anesthetized rats. METHODS: Amitriptyline intoxication was induced by the continuous infusion of amitriptyline 0.625 mg/kg/min throughout the experiment in anesthetized rats. Fifteen and 25 minutes after amitriptyline infusion began, two bolus doses of 10 mg/kg of N-nitro-L-arginine methyl ester (n = 8) or an equivalent volume of 5% dextrose solution (n = 8) was administered to each rat (Protocol 1). To investigate whether the effect of N-nitro-L-arginine methyl ester on blood pressure is counteracted by 3-morpholino sydnonimine, after the same protocol of amitriptyline infusion and 5 minutes after an N-nitro-L-arginine methyl ester bolus, a bolus of 3000 nmol/kg of 3-morpholino sydnonimine was administered (n = 8) to each rat (Protocol 2). To investigate the effect of N-nitro-L-arginine methyl ester on 3-morpholino sydnonimine induced hypotension, a group of rats received a continuous infusion of 0.54 mg/kg/h of 3-morpholino sydnonimine until 50% reduction was observed in mean arterial blood pressure followed by a bolus dose of 10 mg/kg of N-nitro-L-arginine methyl ester (n = 6) or 5% dextrose solution (n = 6) (Protocol 3). Outcome measures included mean arterial blood pressure, heart rate, and QRS duration in electrocardiogram. Student's t test and survival analysis were used for selected comparisons. RESULTS: For all parameters, the treatment groups were similar at baseline and at postamitriptyline periods before therapy was rendered. Amitriptyline infusion significantly reduced mean arterial blood pressure by 50.8 +/- 2.2% and prolonged QRS by 23.9 +/- 7.2% after 15 minutes. In Protocol 1, N-nitro-L-arginine methyl ester significantly increased mean arterial blood pressure compared to dextrose-treated control animals within 30 minutes (77.9 +/- 8.5% vs. 49.7 +/- 5.0% mmHg, p < 0.01, 95% CI 57.1-98.7%). QRS duration progressively increased during the amitriptyline infusion; however, there was no significant difference in QRS width between N-nitro-L-arginine methyl ester and control groups at any time point. N-nitro-L-arginine methyl ester increased survival time compared to controls (33.4 +/- 4.1 vs. 19.9 +/- 2.7 minutes, p < 0.01, 95% CI 25.4-41.3) but did not affect mortality. In Protocol 2 of continuous infusion of amitriptyline, 3-morpholino sydnonimine counteracted the N-nitro-L-arginine methyl ester-induced increase in mean arterial blood pressure. In both protocols, heart rate decreased significantly during amitriptyline infusion but there was no difference between treatment and control groups. In Protocol 3, N-nitro-L-arginine methyl ester bolus reversed 3-morpholino sydnonimine-induced hypotension compared to dextrose bolus. (83.8 +/- 5.7% vs. 54.6 +/- 4.8%, p < 0.01, 95% CI 69.2-98.4). CONCLUSION: N-nitro-L-arginine methyl ester is found to be effective in temporarily improving hypotension and prolonging survival time but does not affect overall mortality. Because this effect was antagonized by 3-morpholino sydnonimine, nitric oxide production appears to contribute to the pathophysiology of amitriptyline-induced hypotension.  相似文献   

15.
1例52岁女性患者,因乳腺癌术后辅助化疗给予曲妥珠单抗220mg加入0.9%氯化钠注射液250ml静脉滴注,滴速为50滴/min。输入约30min时,患者出现寒战、胸闷、口唇发麻、呼吸困难,心率165次/min,血压199/99mm Hg。立即停止输液,行对症治疗。50min后上述症状消失,心率及血压恢复正常。21d后再次化疗,曲妥珠单抗110mg加入0.9%氯化钠注射液250ml静脉滴注,滴速30滴/min。5min后,患者再次出现过敏样症状。停药10min后症状消失。  相似文献   

16.
1例78岁女性2型糖尿病患者因恶心、呕吐、反酸、腹泻3d,先后静脉滴注注射用奥美拉唑钠20mg和乳酸左氧氟沙星氯化钠注射液0.3g。静脉滴注乳酸左氧氟沙星氯化钠注射液约10min后患者出现大汗、心慌、面色苍白、意识淡漠,即测血糖3.0mmol/L。暂停静脉滴注乳酸左氧氟沙星氯化钠注射液,给予葡萄糖氯化钠注射液500ml静脉滴注,并进食糖块、面包,约5min后症状缓解。恢复静脉滴注乳酸左氧氟沙星氯化钠注射液,约5min后前述症状复现,即刻血糖为1.9mmol/L。立即停用乳酸左氧氟沙星氯化钠注射液,静脉推注50%葡萄糖注射液20m1后继续静脉滴注5%葡萄糖注射液500ml,约10min后患者低血糖症状消失,输液结束后血糖升至9.6mmol/L。  相似文献   

17.
目的:探讨麻黄碱对全身麻醉(全麻)患者丙泊酚镇静深度的影响,为麻醉过程中合理应用麻黄碱提供参考。方法:选择美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级、年龄>18岁、拟行非神经外科手术、需要丙泊酚行全麻的患者纳入研究。靶控输注丙泊酚,待血压下降、警觉/镇静评分(OAA/S)=2、脑电双频指数(BIS)稳定持续5 min后,在20~30 s内静脉滴注麻黄碱0.15 mg/kg。记录静脉滴注麻黄碱前、后不同时段心率、脉搏血氧饱和度(SpO2)、右侧桡动脉平均动脉压(MAP)、BIS和OAA/S。结果:共8例患者纳入研究,男性3例,女性5例,平均年龄(50±2)岁,平均体重指数(25.1±3.7)kg/m2。拟行腹腔镜下胆囊切除术者5例,鼻内镜下鼻窦开放术者3例。靶控输注丙泊酚前2 min,患者心率和MAP分别为(81.1±3.0)次/min和(93.3±6.4)mm Hg(1 mmHg=0.133 kPa),给予丙泊酚(13.7±2.3)min后分别下降为(60.2±0.9)次/min和(72.3±5.6)mm Hg,差异有统计学意义(均P<0.01)。给予丙泊酚前、后SpO2分别为(98.1±1.5)%和(97.8±2.4)%,差异无统计学意义(P>0.05)。静脉滴注麻黄碱前2 min MAP为(81.2±6.01)mm Hg,静脉滴注麻黄碱后1~2和3~4 min时段MAP分别升高为(87.0±6.5)和(92.6±7.4)mm Hg,差异均有统计学意义(均P<0.05)。静脉滴注麻黄碱前2 min BIS为68.9±2.1,静脉滴注麻黄碱后5~6、7~8和9~10 min时段BIS分别升高为73.6±2.97、7.7±3.1和79.5±3.0,差异均有统计学意义(P<0.05、P<0.01、P<0.01)。静脉滴注麻黄碱前2 min OAA/S为2.0±0.0,静脉滴注麻黄碱后10 min OAA/S评分升高至3.5±0.3,差异有统计学意义(P<0.05)。BIS峰值较MAP峰值滞后2~4 min出现。结论:丙泊酚全麻过程中静脉滴注麻黄碱可减浅镇静深度,建议根据手术种类和患者情况在静脉滴注麻黄碱后2~4 min内采用有效措施维持麻醉镇静深度。  相似文献   

18.
目的观察高龄患者人工股骨头置换手术中预输注羟乙基淀粉130/0.4扩容对循环的影响。方法选择60例全身麻醉下行人工股骨头置换手术的高龄患者,随机分为观察组(n=30例)和对照组(n=30例)。观察组给予羟乙基淀粉130/0.4氯化钠液500mL,对照组给予复方氯化钠液500mL,均于30min内输注完毕,后均以复方氯化钠液维持。观察两组血压(BP)、心率(HR)、血氧饱和度(SpO2)、低血压的发生率。结果两组患者一般情况,全麻用药无显著性差异,对照组血压(BP)最低值低于观察组,心率(HR)最高值高于观察组,P<0.05有统计学意义。对照组低血压发生率高于观察组,P<0.05为差异有统计学意义。两组血氧饱和度(SPO2)对比无显著性P>0.05。结论高龄人工股骨头置换手术中预防性输液羟乙基淀粉130/0.4可以有效地扩容,维持血压的稳定,有助于围术期维持循环的稳定,有利于提高高龄患者对股骨头置换术的安全性。  相似文献   

19.
We observed the effect of aminophylline administration on estimated hepatic blood flow. Indocyanine green (ICG) 0.5 mg/kg was administered as an intravenous bolus dose before and after intravenous infusion of 7 mg/kg aminophylline. Venous blood was collected at timed intervals over 15 minutes to construct ICG concentration-time graphs. Pharmacokinetic values were calculated using non-compartmental methods. Estimated hepatic blood flow decreased from 790 +/- 190 to 665 +/- 100 ml/minute (p less than 0.05) after administration of aminophylline.  相似文献   

20.
1例57岁女性患者因直肠黑色素瘤切除术后感染,给予左氧氟沙星注射液0.2 g/100 ml静脉滴注,2次/d,用药约20 min时患者出现乏力、盗汗、心悸等症状,急查血糖,为2.7 mmol/L.立即停用左氧氟沙星,静脉滴注10%葡萄糖500 ml,同时进食糖果,上述症状缓解.次日,再次静脉滴注左氧氟沙星约10 min后上述症状复现,即时血糖2.8 mmol/L.再次停用左氧氟沙星并给予对症治疗,症状缓解.改用其他抗生素治疗,患者感染得到控制,未再出现低血糖反应.  相似文献   

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