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临床讨论一、诊断分析病员为食管癌手术后第七天,术后一般情况尚好,于输入血液75毫升后,病情突然恶化,表现有心慌、寒战、呼吸困难,发绀,高热,脉搏加快,血压一时增高,继而下降,进入休克状态,白细胞一度明显减少,很快显著增高。根据上述表现、体检及临床经过,可排除食管癌开胸手术后常见的并发症,如吻合口瘘、肺部并发症等,因为是输血中突然发生,因此应从输血不良反应方面进行考虑。常见的输血不良反应有发热反应、溶血反应、过敏反应、血循环负荷过重反应及细菌污染血液反应等。下面分别加以分析:
Clinical Discussion First, the diagnosis and analysis of patients with esophageal cancer on the seventh day after surgery, the general situation is still good, after entering the blood 75 ml, the condition deteriorated suddenly, showing palpitation, chills, dyspnea, cyanosis, fever, pulse speed, blood pressure A temporary increase, then decline, into the shock state, white blood cells was significantly reduced, quickly increased significantly. According to the above performance, physical examination and clinical after esophageal cancer can rule out common complications after thoracotomy, such as anastomotic fistula, pulmonary complications, because it is a sudden blood transfusion, it should be considered in transfusion adverse reactions. Common adverse reactions of blood transfusion have fever reaction, hemolysis reaction, allergic reaction, overloaded blood circulation reaction and bacterial contamination of blood reaction. The following were analyzed: