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1例51岁男性乙型肝炎肝硬化失代偿期患者因上消化道出血给予静脉滴注生长抑素3 mg持续12 h;兰索拉唑30 mg,1次/12 h;维生素K_1 10 mg,1次/d。维生素K_1和兰索拉唑于2 h输注完毕,患者未出现不适。生长抑素滴注约2.5 h时,患者出现寒颤,呼吸困难,立即停用生长抑素。约10 min后患者出现神志不清、呼之不应,心率160次/min,呼吸32次/min,血压测不到。予面罩吸氧,地塞米松10 mg静脉注射,肾上腺素1 mg皮下注射,异丙嗪25 mg肌内注射。约20 min后,患者逐渐清醒,但精神萎靡,表情淡漠。1.5 h后,寒颤、呼吸困难消失,复查心率110次/min,呼吸23次/min,血压109/50 mmHg(1 mmHg=0.133 kPa)。换用醋酸奥曲肽0.5 mg溶于0.9%氯化钠注射液60 ml,1次/12 h静脉泵入,兰索拉唑、维生素K_1继续治疗,患者未再发生类似症状。
One 51-year-old man with decompensated hepatitis B cirrhosis was given intravenous infusion of somatostatin 3 mg for 12 h; lansoprazole 30 mg, once daily for 12 h; Vitamin K 10 mg , 1 time / d. Vitamin K_1 and lansoprazole infusion at 2 h is completed, the patient did not appear discomfort. When the somatostatin instillation was about 2.5 h, the patient shivering and had difficulty breathing and immediately stopped somatostatin. About 10 min after the patient appeared unconscious, call should not, heart rate 160 beats / min, breathing 32 beats / min, blood pressure can not be measured. To the mask oxygen, dexamethasone 10 mg intravenously, epinephrine 1 mg subcutaneous injection, promethazine 25 mg intramuscular injection. About 20 minutes later, the patient gradually awake, but apathetic, apathy. After 1.5 h, chills and dyspnea disappeared. Heart rate was rechecked 110 times / min, breath 23 times / min and blood pressure 109/50 mmHg (1 mmHg = 0.133 kPa). For octreotide acetate 0.5 mg dissolved in 0.9% sodium chloride injection 60 ml, 1/12 h intravenous infusion, lansoprazole, vitamin K_1 continue treatment, the patient no recurrence of similar symptoms.