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我科收治胸腔积液1例,因抽液过量过速诱发肺水肿而致死,教训沉痛,报告如下。病历摘要男患,18岁,农民。住院号3186。因2月来腹部膨胀、双下肢水肿;近一月来上述症状加重,伴咳嗽、呼吸浅快,不能平卧,于1983年12月8日入院。体检:T35℃,P120次/分,R27次/分,BP110/80mmHg。经临床及X线胸透,提示右侧胸腔大量积液,液平面达第一肋间。胸水及腹水标本均呈血性外观,检出癌细胞。诊断:癌性胸水、腹水,原发癌部位及类型待查。12月9日上午10时30分,于右腋后线第8肋间行胸穿抽水,11时30分术毕,共抽出淡红色胸水2,640ml,术后患者即出现呛咳、烦躁、呼吸困难、不能平卧;从口腔及鼻腔涌出大量红色泡沫痰。考虑系抽胸水过量过速诱发肺水肿,即予鼻导管给氧,静注西地兰0.4mg,口服安定2.5mg,抢救无效,于下午1时30分死亡。
1 cases of hydrothorax admitted to our department, due to excessive fluid pumping induced pulmonary edema and death, painful lessons, the report is as follows. Medical history male suffering, 18 years old, farmer. Hospital number 3186. Due to the abdomen in February to expand, lower extremity edema; the past month to the above symptoms, with cough, shallow breathing, can not lie down, in December 8, 1983 admission. Physical examination: T35 ℃, P120 beats / min, R27 beats / min, BP110 / 80mmHg. The clinical and X-ray thoracotomy, prompted a large pleural effusion on the right side of the liquid level up to the first intercostal space. Pleural effusion and ascites specimens were bloody appearance, detection of cancer cells. Diagnosis: cancerous pleural effusion, ascites, primary cancer sites and types to be investigated. At 10:30 on the December 9th, on the right axillary line 8th intercostal line chest drainage, 11:30 after surgery, a total of 2,640ml out of pink red pleural effusion, postoperative patients that appear cough, irritability, breathing Difficulty, can not lie down; pour a lot of red foam phlegm from the mouth and nasal cavity. Consider the Department of Pulmonary Hyperactivity induced by excessive overdrive of the pleural effusion, that nasal catheter oxygen, intravenous cedilanfil 0.4mg, oral stability 2.5mg, rescue invalid, died at 1:30 pm.