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在心脏疾患治疗中,洋地黄是一种较为常用,且又古老的药物之一,但有时在急诊紧急处理中,判断是否为洋地黄不足抑过量所致,往往会带来一定困难,兹举例并讨论如下: [例1]患者女性,32岁,工人。因心悸、气急加重而来急诊,过去有风心病史,近月来一直在用地高辛0.25mg每天一次,近几天有喉痛、鼻塞。检查,轻度二尖瓣面容,呼吸稍促,唇紫绀,颈静脉充盈,血压110/60,心率132次/分,律齐,心尖区Ⅱ级Dm、Ⅰ～Ⅱ级SM,P_2亢进,心界向左扩大,两肺底少量细湿罗音,腹软,肝肋下一指,无触痛,下肢无凹陷性水肿。诊断:风湿性心脏病,二尖瓣狭窄伴轻度关闭不全,心脏增大,左心衰竭,即给西地兰0.4mg静脉注射,一小时后症状缓解,心率
In the treatment of heart disease, digitalis is one of the more commonly used and ancient drugs, but sometimes in emergency treatment, to determine whether due to overdose caused by digitalis often have some difficulties, give you an example And discuss the following: [Example 1] Female patient, 32 years old, worker. Because of heart palpitations, exacerbations and emergency, past history of rheumatic heart disease, in recent months has been using digoxin 0.25mg once a day, in recent days, sore throat, nasal congestion. Check, mild mitral valve surface, breathing a little, cyanotic lips, filling the jugular vein, blood pressure 110/60, heart rate 132 beats / min, law Qi, apex area Ⅱ Dm, Ⅰ ~ Ⅱ SM, P 2 hyperthyroidism Boundary to the left to expand the two lungs at the end a small amount of fine wet rales, abdominal soft, liver ribs under one finger, no tenderness, lower extremity no pitting edema. Diagnosis: rheumatic heart disease, mitral stenosis with mild incomplete closure, increased heart, left heart failure, that is to give cedilanid 0.4mg intravenous injection, one hour after the onset of symptoms, heart rate