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2例因气喘引起呼吸衰竭患者,经常规治疗无效。在机械性通气后仍有支气管痉挛,用氟烷(halothane)治疗获得成功。 例1 女,32岁,气喘病史4年。长期应用缓释茶碱片、舒喘宁和二丙酸氯地米松气雾剂。急诊时,患者勉力呼吸、哮鸣、发汗、脸色灰紫、血压170/105毫米汞柱。经输氧、皮下注射肾上腺素、间羟舒喘宁、新异丙肾上腺素,静脉注射氨茶碱和氢化可的松,装入容量通气机,进入加强护理单位。但气喘仍继续恶化,动脉血气分析,pH7.17,PCO_258。气管内给予异丙肾上腺素仅有短暂的效果。用麻醉机使氟烷与氧气施于病人,剂量滴加到0.5%和3%之间,保持收缩压大于100毫米汞柱。
2 cases of respiratory failure caused by asthma patients, the conventional treatment ineffective. Bronchospasm is still present after mechanical ventilation and is successfully treated with halothane. Example 1 Female, 32 years old, history of asthma 4 years. Long-term use of sustained-release theophylline tablets, salbutamol and beclomethasone dipropionate aerosol. Emergency, the patient managed to breathe, wheezing, sweating, pale purple, blood pressure 170/105 mm Hg. Adoptive oxygen, subcutaneous injection of epinephrine, methotrexate, neo-isoproterenol, intravenous aminophylline and hydrocortisone, into the capacity of the ventilator, access to intensive care unit. But asthma continued to worsen, arterial blood gas analysis, pH7.17, PCO_258. Endotracheal administration of isoproterenol has only a transient effect. Halothane and oxygen are administered to the patient using an anesthetic machine and the dose is added dropwise between 0.5% and 3% to maintain a systolic blood pressure greater than 100 mmHg.