糖尿病酮症酸中毒并急性心肌梗塞、室颤抢救成功1例

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1 病例报告患者女,52岁。有Ⅱ型糖尿病史11年,冠心病史10年。因咳嗽、咯痰、烦渴、多饮、多尿、胸闷20天,加重伴呼吸困难1天于1998—12—31入院。查体:35.9℃,血压18.7/12.0kPa(140/90mmHg),呼吸26/min,脉搏130/mim。端坐位,口唇发绀,颈静脉轻度充盈。双肺可闻及广泛干、湿啰音。心界向左扩大,心率142/min,绝对不齐,第一心音弱,心尖区可闻舒张期奔马律。双下肢轻度浮肿。化验:血白细胞21.3×10~9/L,分叶0.93,血搪31.6mmol/L。尿糖++++,尿酮++,尿蛋 A case report patient female, 52 years old. 11 years history of type 2 diabetes and 10 years history of coronary heart disease. Due to cough, expectoration, polydipsia, polydipsia, polyuria, chest tightness 20 days, increased with dyspnea 1 day admitted in 1998-12-31. Examination: 35.9 ℃, blood pressure 18.7 / 12.0kPa (140 / 90mmHg), breathing 26 / min, pulse 130 / mim. Sitting side, lips cyanosis, mild jugular filling. Lung can be heard a wide range of dry and wet rales. Heart to the left to expand, the heart rate 142 / min, absolutely missing, the first heart sound weak, apex area can be heard diastolic gallop. Lower extremity mild edema. Laboratory tests: Blood leukocytes 21.3 × 10 ~ 9 / L, leaf 0.93, blood enamel 31.6mmol / L. Urine ++++, Urine K +, Urine egg
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