{"id":176,"date":"2023-12-28T11:39:34","date_gmt":"2023-12-28T03:39:34","guid":{"rendered":"https:\/\/www.scipmed.cn\/?p=176"},"modified":"2024-01-09T14:03:16","modified_gmt":"2024-01-09T06:03:16","slug":"%e6%80%a5%e8%af%8a%e6%a1%88%e4%be%8b%e8%85%b9%e7%97%9b%e4%b8%ba%e4%b8%bb%e8%a6%81%e7%97%87%e7%8a%b6%e7%9a%84%e7%b3%96%e5%b0%bf%e7%97%85%e6%80%a7%e4%b9%b3%e9%85%b8%e9%85%b8%e4%b8%ad%e6%af%921%e4%be%8b","status":"publish","type":"post","link":"https:\/\/cspmmed.com\/?p=176","title":{"rendered":"\u6025\u8bca\u6848\u4f8b|\u8179\u75db\u4e3a\u4e3b\u8981\u75c7\u72b6\u7684\u7cd6\u5c3f\u75c5\u6027\u4e73\u9178\u9178\u4e2d\u6bd21\u4f8b"},"content":{"rendered":"\n

\u4e13\u5bb6\u7b80\u4ecb<\/strong><\/p>\n\n\n\n

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\u60a3\u8005<\/strong><\/p>\n\n\n\n

\u7537\u6027\uff0c76\u5c81\u3002<\/p>\n\n\n\n

\u4e3b\u8bc9 <\/strong><\/p>\n\n\n\n

\u95f4\u65ad\u5455\u5410\u3001\u8179\u6cfb5\u5929\uff0c\u7a81\u53d1\u8179\u75db1\u5c0f\u65f6\u3002<\/p>\n\n\n\n

\u73b0\u75c5\u53f2<\/strong><\/p>\n\n\n\n

\u60a3\u80055\u5929\u524d\u65e0\u660e\u786e\u8bf1\u56e0\u51fa\u73b0\u8179\u6cfb\uff0c\u4e3a\u7a00\u6c34\u6837\u4fbf\uff0c\u91cf\u591a\uff0c\u5177\u4f53\u4e0d\u8be6\uff0c\u95f4\u65ad\u5455\u5410\u80c3\u5185\u5bb9\u7269\uff0c\u4f34\u8f7b\u5fae\u5de6\u4e0a\u8179\u949d\u75db\uff0c\u65e0\u53d1\u70ed\uff0c\u81ea\u670d\u5de6\u6c27\u6c1f\u6c99\u661f\u540e\u8179\u6cfb\u6709\u6240\u7f13\u89e3\uff0c\u4ecd\u95f4\u65ad\u5455\u5410\uff0c\u98df\u6b32\u4e0b\u964d\uff0c\u8fdb\u98df\u6c34\u5c11\u3002\u6765\u8bca\u5f53\u65e5\u521d\u8bca\u4e3a\u201c\u6025\u6027\u80c3\u80a0\u708e\u201d\u4e8e\u7559\u89c2\u5ba4\u8f93\u6db2\u6cbb\u7597\uff0c\u671f\u95f4\u7a81\u53d1\u6301\u7eed\u6027\u5de6\u4e2d\u4e0a\u8179\u5267\u70c8\u7ede\u75db\uff0c\u96be\u4ee5\u5fcd\u53d7\uff0c\u65e0\u5176\u4ed6\u90e8\u4f4d\u653e\u5c04\uff0c\u65e0\u5bd2\u6218\u3001\u6076\u5fc3\u3001\u5455\u5410\uff0c\u65e0\u8170\u75db\u3001\u8840\u5c3f\uff0c\u65e0\u80f8\u75db\u3001\u80f8\u95f7\u3001\u547c\u5438\u56f0\u96be\u53ca\u5927\u6c57\uff0c\u8179\u75db\u6301\u7eed\u4e0d\u7f13\u89e3\u8f6c\u5165\u62a2\u6551\u5ba4\u3002<\/p>\n\n\n\n

\u65e2\u5f80\u53f2<\/strong><\/p>\n\n\n\n

\u9ad8\u8840\u538b\u75c520\u5e74\uff0c\u8840\u538b\u6700\u9ad8200\/100 mmHg\uff0c\u5e73\u7d20\u8840\u538b\u63a7\u5236\u8f83\u597d\u3002\u201c\u51a0\u5fc3\u75c5\u201d\u591a\u5e74\uff0c\u4f46\u672a\u66fe\u6709\u80f8\u95f7\u3001\u80f8\u75db\u53d1\u4f5c\uff0c\u4ea6\u672a\u884c\u8fdb\u4e00\u6b65\u68c0\u67e5\u30022\u578b\u7cd6\u5c3f\u75c516\u5e74\uff0c\u66fe\u670d\u836f\u53ca\u6ce8\u5c04\u80f0\u5c9b\u7d20\u6cbb\u7597\u6548\u679c\u4e0d\u4f73\uff0c2\u5e74\u524d\u5f00\u59cb\u670d\u7528\u975e\u6b63\u89c4\u533b\u9662\u201c\u4e2d\u836f\u201d\u6cbb\u7597\uff0c\u8840\u7cd6\u660e\u663e\u4e0b\u964d\u3002\u7cd6\u5c3f\u75c5\u80be\u75c510\u5e74\u3002\u9611\u5c3e\u5207\u9664\u672f\u540e30\u4f59\u5e74\u3002<\/p>\n\n\n\n

\u5bb6\u65cf\u53f2<\/strong><\/p>\n\n\n\n

\u7cd6\u5c3f\u75c5\u5bb6\u65cf\u53f2\u3002<\/p>\n\n\n\n

\u4f53\u683c\u68c0\u67e5<\/strong><\/p>\n\n\n\n

T 36.0\u2103\uff0cR 20\u6b21\/min\uff0cP 92\u6b21\/min\uff0cBP 180\/100 mmHg\uff08\u53cc\u4e0a\u80a2\u76f8\u7b49\uff09\u3002\u795e\u5fd7\u6e05\u695a\uff0c\u70e6\u8e81\u4e0d\u5b89\uff0c\u7a0d\u6709\u51fa\u6c57\uff0c\u56db\u80a2\u6e7f\u51b7\uff0c\u9888\u9759\u8109\u65e0\u6012\u5f20\uff0c\u53cc\u80ba\u547c\u5438\u97f3\u7c97\uff0c\u53f3\u4e0b\u80ba\u53ef\u95fb\u53ca\u6e7f\u5570\u97f3\u3002\u5fc3\u738792\u6b21\/min\uff0c\u5f8b\u9f50\uff0c\u5fc3\u97f3\u6709\u529b\uff0c\u672a\u95fb\u53ca\u6742\u97f3\u3002\u8179\u90e8\u7a0d\u9686\u8d77\uff0c\u8179\u808c\u8f83\u8f6f\uff0c\u5168\u8179\u538b\u75db\uff0c\u4ee5\u5de6\u4e0a\u8179\u4e3a\u8457\uff0c\u65e0\u53cd\u8df3\u75db\uff0cMurphy\u5f81\uff08-\uff09\uff0c\u9ea6\u6c0f\u70b9\u538b\u75db\u4e0e\u5176\u4ed6\u90e8\u4f4d\u65e0\u5dee\u5f02\uff0c\u809d\u813e\u808b\u4e0b\u672a\u89e6\u53ca\uff0c\u5168\u8179\u672a\u89e6\u53ca\u5305\u5757\uff0c\u8179\u90e8\u6263\u8bca\u4e3a\u9f13\u97f3\uff0c\u809d\u813e\u6d4a\u97f3\u533a\u5b58\u5728\uff0c\u79fb\u52a8\u6027\u6d4a\u97f3\u60a3\u8005\u65e0\u6cd5\u914d\u5408\u68c0\u67e5\uff0c\u542c\u8bca3 min\u672a\u95fb\u53ca\u80a0\u9e23\u97f3\u3002\u53cc\u4fa7\u80a2\u4f53\u8109\u640f\u6ce2\u52a8\u5bf9\u79f0\uff0c\u53cc\u4e0b\u80a2\u65e0\u6c34\u80bf\u3002<\/p>\n\n\n\n

\u8f85\u52a9\u68c0\u67e5<\/strong><\/p>\n\n\n\n

\u5e8a\u65c1\u5feb\u901f\u8840\u7cd61.3 mmol\/L\u3002<\/p>\n\n\n\n

\u52a8\u8109\u8840\u6c14\u5206\u6790\uff1apH 6.78\uff0cPO2<\/sub> 141 mmHg\uff0cPCO2<\/sub> 22 mmHg\uff0cHCO3<\/sub> 3.1 mmol\/L\uff0cBE \ufe6328.1 mmol\/L\u3002<\/p>\n\n\n\n

\u8840\u5e38\u89c4\uff1aWBC 8.73\u00d7109<\/sup>\/L\uff0cN 80.9%\uff0cHGB 126 g\/L\uff0cPLT 308\u00d7109<\/sup>\/L\u3002<\/p>\n\n\n\n

\u8840\u751f\u5316\uff1a\u809d\u529f\u6b63\u5e38\uff0cCRE 258 mmol\/L\uff0cUREA 13.65 mmo\/L\uff0cGLU 1.1 mmol\/L\uff0cCa 2.56 mmol\/L\uff0cK+<\/sup> 4.4 mmol\/L\uff0cNa+<\/sup> 142mmol\/L\uff0cCl\ufe63<\/sup> 95.5 mmol\/L\uff0cAMY 93 \uff35\/L\uff1b\u8840\u4e73\u9178 22.40 mmol\/L\uff0cNH3<\/sub> 202 \u03bcg\/dl\uff1bD-dimer 524.1 ng\/ml\uff1b\u5fc3\u808c\u6897\u6b7b\u4e09\u9879\uff08CK-MB\u3001MYO\u3001TNI\uff09\u6b63\u5e38\uff0cBNP 229 pg\/ml\uff0cPCT 6.61 ng\/ml\u3002<\/p>\n\n\n\n

\u5c3f\u5e38\u89c4\uff1a\u6bd4\u91cd\u22651.030\uff0cKET 1.5 mmol\/L\uff0cPRO 0.3 g\/L\u3002<\/p>\n\n\n\n

\u80c3\u6db2OB\uff1a+++\u3002<\/p>\n\n\n\n

\u5fc3\u7535\u56fe\uff1a\u65e0ST-T\u5f02\u5e38\u3002<\/p>\n\n\n\n

\u8179\u90e8\u8d85\u58f0\uff1a\u809d\u80c6\u80f0\u813e\u53cc\u80be\u672a\u89c1\u5f02\u5e38\u3002<\/p>\n\n\n\n

\u8179\u5e73\u7247\uff1a\u8188\u4e0b\u672a\u89c1\u6e38\u79bb\u6c14\u4f53\uff0c\u80c3\u5185\u5927\u91cf\u79ef\u6c14\uff0c\u4e2d\u4e0a\u8179\u5f25\u6f2b\u5206\u5e03\u79ef\u6c14\u80a0\u7ba1\uff0c\u80a0\u7ba1\u58c1\u53ef\u89c1\u5f39\u7c27\u7ebf\u72b6\u5f71\uff0c\u5e76\u53ef\u89c1\u591a\u53d1\u6db2\u6c14\u5e73\u9762\uff0c\u63d0\u793a\u5c0f\u80a0\u6897\u963b\u53ef\u80fd\u3002<\/p>\n\n\n\n

\u80f8\u7247\uff1a\u5de6\u4e0b\u80ba\u5c11\u8bb8\u708e\u75c7\u53ef\u80fd\uff0c\u5fc3\u5f71\u589e\u5927\u3002<\/p>\n\n\n\n

\u521d\u6b65\u8bca\u65ad<\/strong><\/p>\n\n\n\n

2\u578b\u7cd6\u5c3f\u75c5<\/p>\n\n\n\n

\u4f4e\u8840\u7cd6\u75c7<\/p>\n\n\n\n

\u4e73\u9178\u6027\u9178\u4e2d\u6bd2<\/p>\n\n\n\n

\u7cd6\u5c3f\u75c5\u80be\u75c5<\/p>\n\n\n\n

\u6162\u6027\u80be\u529f\u80fd\u4e0d\u5168\u6025\u6027\u52a0\u91cd<\/p>\n\n\n\n

\u8179\u75db\u67e5\u56e0<\/p>\n\n\n\n

\u5c0f\u80a0\u6897\u963b<\/p>\n\n\n\n

\u5e94\u6fc0\u6027\u6e83\u75a1<\/p>\n\n\n\n

\u6025\u6027\u80c3\u80a0\u708e\uff1f<\/p>\n\n\n\n

\u793e\u533a\u83b7\u5f97\u6027\u80ba\u708e\uff1f<\/p>\n\n\n\n

\u9ad8\u8840\u538b\u75c5<\/p>\n\n\n\n

\u6cbb\u7597\u7ecf\u8fc7<\/strong><\/p>\n\n\n\n

\u5feb\u901f\u6709\u5e8f\u8fdb\u884c\u5404\u79cd\u8f85\u52a9\u68c0\u67e5\u7684\u540c\u65f6\uff0c\u7acb\u5373\u79ef\u6781\u62a2\u6551\u3002<\/p>\n\n\n\n

\u9488\u5bf9\u4f4e\u8840\u7cd6\uff0c\u7ed9\u4e8825%\u8461\u8404\u7cd6\u6ce8\u5c04\u6db260 ml\u9759\u8109\u63a8\u6ce8\u540e\u7eed\u4ee510%\u8461\u8404\u7cd6\u6ce8\u5c04\u6db2\u6301\u7eed\u9759\u8109\u8f93\u6ce8\uff0c\u8840\u7cd6\u5f88\u5feb\u6062\u590d\u5e76\u4e00\u76f4\u4fdd\u6301\u6b63\u5e38\u6216\u7565\u504f\u9ad8\u6c34\u5e73\u3002<\/p>\n\n\n\n

\u56e0\u9178\u4e2d\u6bd2\u4e25\u91cd\uff0c\u7acb\u5373\u79ef\u6781\u8865\u6db2\u5e76\u9759\u8109\u8f93\u6ce85% NaHCO3<\/sub>\uff0c\u5bc6\u5207\u76d1\u6d4b\u52a8\u8109\u8840\u6c14\u53ca\u8840\u7535\u89e3\u8d28\u3001\u4e73\u9178\uff0c\u5e76\u6839\u636e\u7ed3\u679c\u8c03\u6574\u7528\u91cf\u53ca\u6ef4\u901f\uff0c\u81f3\u6b21\u65e5\u4e0a\u534818\u5c0f\u65f6\u5185\u8f93\u6ce85% NaHCO3<\/sub>\u5171\u8ba12000 ml\uff0c\u8840pH\u503c\u8fbe7.23\u505c\u7528\u3002\u5176\u95f4\u60a3\u8005\u5148\u540e\u51fa\u73b0\u8fc7\u6301\u7eed\u6027\u4f4e\u8840\u538b\uff0885\/45 mmHg\u5de6\u53f3\uff09\u3001\u4e00\u8fc7\u6027\u5fc3\u7387\u4e0b\u964d\uff0835\u6b21\/min\uff09\u53ca\u53cd\u590d\u9891\u7e41\u5168\u8eab\u62bd\u6410\u4f34\u610f\u8bc6\u4e27\u5931\uff0c\u7ecf\u5feb\u901f\u8865\u6db2\u3001\u7ea0\u9178\u3001\u8840\u7ba1\u6d3b\u6027\u836f\uff08\u591a\u5df4\u80fa\u6700\u5927\u7528\u91cf20 \u00b5g\/\uff08min\u00b7kg\uff09\u4ee5\u53ca\u53cd\u590d\u5730\u897f\u6cee\u9759\u8109\u63a8\u6ce8\u6cbb\u7597\u6548\u679c\u4e0d\u4f73\u5e76\u51fa\u73b0\u4e8c\u6c27\u5316\u78b3\u6f74\u7559\uff08PCO2<\/sub> 58 mmHg\uff09\uff0c\u7acb\u5373\u7ed9\u4e88\u6c14\u7ba1\u63d2\u7ba1\u3001\u547c\u5438\u673a\u8f85\u52a9\u547c\u5438\uff0c\u4e4b\u540e\u5f88\u5feb\u5faa\u73af\u7cfb\u7edf\u7a33\u5b9a\uff0c\u62bd\u6410\u505c\u6b62\u3002<\/p>\n\n\n\n

\u8be5\u60a3\u8005\u6709\u884c\u6025\u8bca\u5e8a\u65c1\u8840\u6db2\u51c0\u5316\u6cbb\u7597\u6307\u5f81\uff0c\u4f46\u56e0\u5bb6\u5c5e\u4e0d\u540c\u610f\u800c\u672a\u8fdb\u884c\u3002<\/p>\n\n\n\n

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\u6c14\u7ba1\u63d2\u7ba1\u547c\u5438\u673a\u8f85\u52a9\u547c\u5438\u6cbb\u7597\u5f53\u5929\u4e0b\u5348\uff08\u6765\u8bca\u7b2c2\u5929\uff09\u505c\u7528\u9547\u9759\u836f\uff0c\u60a3\u8005\u795e\u5fd7\u6e05\u695a\uff0c\u65e0\u4e0d\u9002\u4e3b\u8bc9\uff0c\u8179\u75db\u7f13\u89e3\u3002<\/p>\n\n\n\n

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