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患者,男,20岁,民工。于2000年8月14日上午7时50分,不慎右手触电(220V),由高2m的墙上摔下,当即出现神志不清与抽搐,现场进行不规范的心脏按压。约20分钟后被送来我院急诊科。查体;意识丧失,面色苍白,两瞳孔极度散大,对光反射消失,呼吸心跳消失,血压0,右手食指、中指约有1.5cm左右的电灼伤,深达骨膜,心电图直线。来急诊后立即进行胸外叩击两次,并行心脏按压,人工呼吸按4:1进行,同时迅速建立两上肢静脉通道,气管插管,氧气吸入4～6L/min。8时整,给予气管滴入副肾素1mg,同时静脉推注副肾素2mg,氟美松10mg,阿托品1mg。5分钟后仍无呼吸心跳,又给予5mg副肾素静脉推注,阿托品1mg静脉推注。6分钟后从心电监护仪中可见室颤波,并给予非同步200J叠加电除颤连续3次。此后静脉推注5%碳酸氢钠50ml。又分次静脉推注副肾索13mg。9时10分,患者出现心跳,并相继出现自主呼吸,瞳孔开始缩小。颈动脉可触及微弱博动,心电监护示室性自主心律,约5钟后又出现心室纤颤,立即给予280J非同步电除颤,又给予刊多卡因100mg静脉推注,后转为窦性心动过速。静脉推注5%碳酸氢钠50ml,并同时给以低分子右旋糖酐250ml加多巴胺60mg静滴,到10时50分左右,血压回升至90～105mmHg/70～80mmHg,呼吸48次/min,心率180次/min,并相继出现抽搐,给予静脉快滴20%甘露醇、速尿、氟美松减轻脑水肿,安定静脉推注止痉,西地兰控制心衰,心律平静脉滴注治疗室上性心动过速。至下午3时,患者病情稳定,心律转为窦性,心率
Patient, male, 20 years old, laborer. On August 14, 2000, at 7:50 am, his right hand electric shock (220V) was accidentally dropped from the wall with a height of 2m. Immediate unconsciousness and convulsions were observed. Non-standard heart pressure was applied to the scene. About 20 minutes later was sent to our hospital emergency department. Consciousness loss, pale, two pupils extremely scattered, the light reflection disappear, breathing heart rate disappear, blood pressure 0, right index finger, middle finger about 1.5cm electric burn, deep periosteum, ECG line. Thoracic tapping was performed twice immediately after the emergency, followed by cardiac compression and artificial resuscitation at 4: 1. At the same time, two upper extremity venous access and endotracheal intubation were performed, and oxygen was inhaled 4 to 6 L / min. At 8 o’clock, the patient was given an intra-arterial infusion of adrenaline 1 mg while intravenous injection of 2 mg of adrenolein, dexamethasone 10 mg and atropine 1 mg. Still no breathing after 5 minutes, and given intravenous injection of 5mg adrenaline, atropine 1mg intravenous injection. Ventricular fibrillation was seen in the ECG after 6 minutes and was given asynchronously 200J stacker defibrillation three times in a row. After intravenous injection of 5% sodium bicarbonate 50ml. Another sub-renal vein cable 13mg. 9:10, patients with heartbeat, and spontaneous breathing have emerged, the pupil began to shrink. Carotid artery can touch the weak motility, ECG monitoring of ventricular autonomy showed ventricular fibrillation after about 5 minutes, immediately given 280J non-synchronized defibrillation, but also given intravenous injection of lidocaine 100mg, and then converted to sinus Tachycardia. Intravenous injection of 5% sodium bicarbonate 50ml, and at the same time give low molecular dextran 250ml dopamine 60mg intravenous infusion, to 10:50 or so, the blood pressure rose to 90 ~ 105mmHg / 70 ~ 80mmHg, breathing 48 beats / min, heart rate 180 Times / min, and have convulsions, giving intravenous drip 20% mannitol, furosemide, flumethazone alleviate cerebral edema, stability of intravenous injection Zhijing, cedilanor control heart failure, intravenous infusion of venous venous treatment room Tachycardia. To 3 pm, patients in stable condition, heart rate to sinus, heart rate