肺栓塞1例

Pulmonary embolism:a case report

患者，男，28岁。因“突发神志不清1h”于2012—10—08入院。患者夜间23时许解大便时突发意识不清摔倒在地，呼之不应，伴双目向上凝视，全身湿冷，面色苍白，约3min后家属唤醒，自诉喝糖水，给予糖水约4min后患者再次意识不清，呼之不应，呕吐3次，呕吐物为胃内容物。

A 28 year-old patient who had sudden unconscious for 1 hour were admitted to our hospital. The blood pressure couldn＇t he detected, HR 140 bpm, arrhythmia. Outpatient cranial CT scan showed no obvious ab- normalities. The patient accepted infusion after admission and the dopamine was infused by pump. The patient ad- mitted into ICU for care treatment. PE..T 35.0 ℃ ,HR 121 bpm,R 30 bpm,BP 87/56 mmHg,SaO2 92%. The pa-tient was unconscious and uncooperative. The voice and pain stimulus response was poor. The bilateral pupil was normal. D=3. 5 mm, The light reflection was sensitive. Double side lung breath sounds was clear. No dry/wet rales, arrhythmia and premature beat can be beard. No significant pathological noise can be heard at each valve are-a. There was no edema of the left lower limb. The right lower limb had mild edema,and was more sturdy than left. Right knee had a scar and double side pathological sign were negative. Admission blood gas analysis： pH7. 345, PO2 71 mmHg, PCO2 27.3 mmHg, HCO3 15.2 retool/L, BE-11 mmol/L, SaO2 95%, Lac 8.04 mmol/L,D2 polymers.. 8 125 mg/L. Double lower limb deep vein color dopplar ultrasound showed：the right lower limb popliteal vein and posterior tibial venous thromboses. Left popliteal vein blood flow speed was slowly. Pulmonary CTA： ① Diffuse pulmonary embol.ism ②Double side lung had a little interstitial venereal change. Diagnosis：acute pulmonary embolism （acute pulmonary thrombo embolism,APTE）.