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例1:患者女,62岁.咳嗽、咳痰反复发作20年,气促伴双下肢浮肿5年,加重20天入院.查体:神清、皮肤、粘膜无发绀.颈静脉充盈.气管居中,桶状胸,两肺闻及干、湿性罗音.心律规则,心率106次/分.肝右肋下2cm.肝颈返流阳性,脾脏未触及.双下肢浮肿.诊断:慢性支气管炎并发感染,肺气肿、肺心病、右心衰竭.心电图示:窦性心动过速,肺型P波.经抗炎、利尿等治疗后,症状明显改善.住院期间查空腹血糖为10.1mmol/L,考虑有Ⅱ型糖尿病存在.加用优降糖2.5mg,po,Bid,患者服优降糖2.5mg后约3小时,被发现神志不清.急测血糖、血电解质检查,同时心电监护.血糖为2.28mmol/L,血K~+4.lmmol/L.心电监护开始为窦性心律,后转为室性过速.静脉注射50%葡萄糖60ml,转为窦性心律,神志渐转清.后改用达美康等综合治疗,好转出院.
Case 1: Female patient, aged 62. Cough and expectoration repeated episodes of 20 years, with shortness of breath and edema of lower extremities for 5 years, increased 20 days admitted to hospital Physical examination: Shen Qing, skin, mucosa without cyanosis. Jugular vein filling. Tracheal center , Barrel chest, lung and smell of dry and wet rales .Rhythm of heart rate, heart rate 106 beats / min.Har right rib 2cm.Liver neck reflux is positive, the spleen not touched.Double lower extremity edema.Diagnosis of chronic bronchitis Infection, emphysema, pulmonary heart disease, right heart failure.Electrocardiogram showed: sinus tachycardia, pulmonary P wave.After anti-inflammatory, diuretic and other treatment, the symptoms were significantly improved .Fetal inpatient check fasting blood glucose was 10.1mmol / L , Consider the presence of type II diabetes plus glyburide 2.5mg, po, Bid, patients taking glyburide 2.5mg after about 3 hours, was found unconscious. Rapid blood glucose, blood electrolyte test, while ECG Blood glucose was 2.28mmol / L, blood K ~ + 4.lmmol / L. ECG monitoring began as sinus rhythm, then converted to ventricular tachycardia intravenous injection of 50% glucose 60ml, into sinus rhythm, gradually Turn clear. After the switch to Delta therapy and other comprehensive treatment, improved discharge.