鑰冭│娴佺▼

 

缍�(w菐ng)涓婂牨(b脿o)鍚�	鐝�(xi脿n)鍫�(ch菐ng)纰鸿獚(r猫n)	鎵撳嵃婧�(zh菙n)鑰冭瓑	鑰冭│瀵�(sh铆)鏂�	鎴愮妇(j墨)鏌ヨ	闋�(l菒ng)鍙栨垚绺�(j墨)鍠�
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鑰冭│浠嬬垂

銆€銆€鐐鸿搏寰瑰湅(gu贸)瀹朵汉浜嬮儴銆佽(w猫i)鐢熼儴銆婇棞(gu膩n)浜庡姞寮�(qi谩ng)琛�(w猫i)鐢熷皥妤�(y猫)鎶€琛�(sh霉)鑱峰嫏(w霉)瑭�(p铆ng)鑱樺伐浣滅殑閫氱煡銆嬬瓑鐩搁棞(gu膩n)鏂囦欢鐨勭簿绁�锛岃嚜2001骞村叏鍦�(gu贸)琛�(w猫i)鐢熷皥妤�(y猫)鍒�銆佷腑绱�(j铆)鎶€琛�(sh霉)璩囨牸浠ヨ€冧唬瑭�(p铆ng)宸ヤ綔姝ｅ紡瀵�(sh铆)鏂姐€傞€氶亷(gu貌)鑰冭│鍙栧緱鐨勮硣鏍间唬琛ㄤ簡鐩告噳(y墨ng) 绱�(j铆)鍒ユ妧琛�(sh霉)鑱峰嫏(w霉)瑕佹眰鐨勬按骞宠垏鑳藉姏锛屼綔鐐哄柈浣嶈仒浠荤浉鎳�(y墨ng)鎶€琛�(sh霉)鑱峰嫏(w霉)鐨勫繀瑕佷緷鎿�(j霉)銆�

銆€銆€涓€銆佸│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯硣鏍艰€冭│鑼冨湇

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銆€?銆偳橆應鈹涜崥鍤抽鍚璒(sh猫)缃細鑰冭│鍏卞垎鈥滃熀绀�(ch菙)鐭ヨ瓨(sh铆)鈥�銆佲€滅浉闂�(gu膩n)灏堟キ(y猫)鐭ヨ瓨(sh铆)鈥濄€佲€滃皥妤�(y猫)鐭ヨ瓨(sh铆)鈥�銆佲€滃皥妤�(y猫)瀵�(sh铆)韪愯兘鍔涒€濈瓑4鍊�(g猫)绉戠洰锛屽潎閲囩敤浜烘(j墨)灏�(du矛)瑭辩殑鏂瑰紡閫�(j矛n)琛岃€冭│銆�

銆€銆€浜屻€佸│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯硣鏍煎彇寰楁柟寮�

銆€銆€濠︾敘(ch菐n)绉戜富娌婚啱(y墨)甯硣鏍艰€冭│瀵�(sh铆)琛屽叏鍦�(gu贸)绲�(t菕ng)涓€绲勭箶銆佺当(t菕ng)涓€鑰冭│鏅�(sh铆)闁�銆佺当(t菕ng)涓€鑰冭│澶х侗銆佺当(t菕ng)涓€鑰冭│鍛介銆佺当(t菕ng)涓€鍚堟牸妯�(bi膩o)婧�(zh菙n)鐨勮€冭│鍒跺害锛屽師鍓囦笂姣忓勾閫�(j矛n)琛屼竴娆�銆�

銆€銆€鍑″垪鍏ュ叏鍦�(gu贸)鑰冭│鐨勫皥妤�(y猫)锛屼笉鍐嶉€�(j矛n)琛屽垵銆佷腑绱�(j铆)琛�(w猫i)鐢熷皥妤�(y猫)鎶€琛�(sh霉)鑱峰嫏(w霉)浠昏伔璩囨牸鐨勮獚(r猫n)瀹氬拰瑭�(p铆ng)瀵�锛屼笉鍐嶇祫绻斿垵銆佷腑绱�(j铆)琛�(w猫i)鐢熸妧琛�(sh霉)绯诲垪鐨勫皥妤�(y猫)鑰冭│銆�

銆€銆€涓�銆佸│鐢�(ch菐n)绉戜富娌婚啱(y墨)甯硣鏍艰瓑鏇�(sh奴)绠＄悊

銆€銆€鍙冨姞?j矛)D鐢�(ch菐n)绉戜富娌婚啱(y墨)甯硣鏍艰€冭│骞舵垚绺�(j墨)鍚堟牸鑰�锛岀敱浜轰簨灞€闋掔櫦(f膩)浜轰簨閮ㄧ当(t菕ng)涓€鍗板埗锛屼汉浜嬮儴銆佽(w猫i)鐢熼儴鐢ㄥ嵃鐨勫皥妤�(y猫)鎶€琛�(sh霉)璩囨牸璀夋浉(sh奴)銆傝┎璀夋浉(sh奴)鍦ㄥ叏鍦�(gu贸)鑼冨湇鍏�(n猫i)鏈夋晥銆�

銆€銆€鏈変笅鍒楁儏褰箣涓€鐨�锛岀敱琛�(w猫i)鐢熷眬鍚婇姺(xi膩o)鍏剁浉鎳�(y墨ng)灏堟キ(y猫)鎶€琛�(sh霉)璩囨牸锛岀敱浜轰簨灞€鏀跺洖鍏跺皥妤�(y猫)鎶€琛�(sh霉)璩囨牸璀夋浉(sh奴)锛�2骞村収(n猫i)涓嶅緱鍙冨姞?j矛)D鐢�(ch菐n)绉戜富娌婚啱(y墨)甯硣鏍艰€冭│锛�

銆€?銆傘剴鍞工鍗ч瀭W(xu茅)姝锋垨?q奴)顥滻(y猫)鎶€琛�(sh霉)宸ヤ綔璩囨璀夋槑锛�

銆€?銆偳橆應鈹涜崥鍤婚檪g鏈夐仌绱€(j矛)琛岀偤锛�

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鑰冭│澶х侗

銆€銆€濠︾敘(ch菐n)绉戜富娌婚啱(y墨)甯€冭│澶х侗涓€鑸渻(hu矛)鍦ㄨ€冭│鍓嶄竴鍊�(g猫)骞村害鐨�12鏈堜唤鑷宠€冭│鐣�(d膩ng)骞寸殑1鏈堜唤宸﹀彸鍏竷銆�

鍫�(b脿o)鍚嶆浠�

銆€銆€鍑＄鍚堣(w猫i)鐢熼儴銆佷汉浜嬮儴鍗扮櫦(f膩)鐨勩€婅嚚搴婇啱(y墨)瀛�(xu茅)灏堟キ(y猫)鎶€琛�(sh霉)璩囨牸鑰冭│鏆瑕�(gu墨)瀹氥€嬶紙琛�(w猫i)浜虹櫦(f膩)[2000]462铏�(h脿o)锛変腑鍫�(b脿o)鍚嶆浠剁殑浜哄摗锛屽潎鍙牨(b脿o)鍚嶅弮鍔犵浉鎳�(y墨ng)绱�(j铆)鍒ュ拰灏堟キ(y猫)椤�(l猫i)鍒ョ殑鑰冭│銆�

銆€銆€濠︾敘(ch菐n)绉戝(xu茅)灏堟キ(y猫)锛�

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銆€?銆�?锛夐伒瀹堜腑鑿汉姘戝叡鍜屽湅(gu贸)鐨勬啿娉曞拰娉曞緥锛�

銆€?銆�?锛夐伒瀹堛€婁腑鑿汉姘戝叡鍜屽湅(gu贸)鍩�(zh铆)妤�(y猫)閱�(y墨)甯硶銆�锛屽苟鍙栧緱鍩�(zh铆)妤�(y猫)閱�(y墨)甯硣鏍�锛�

銆€?銆�?锛夊叿鍌欒壇濂界殑閱�(y墨)寰烽啱(y墨)棰�(f膿ng)鍜屾暚妤�(y猫)绮剧锛�

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銆€?銆�?锛夊彇寰楅啱(y墨)瀛�(xu茅)涓皥瀛�(xu茅)姝凤紝鍙楄仒鎿�(d膩n)浠婚啱(y墨)甯伔鍕�(w霉)婊�7骞�銆�

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銆€銆€鍫�(b脿o)鍚嶆浠朵腑瀛�(xu茅)姝锋垨?q奴)W浣嶇殑瑕�(gu墨)瀹�锛屾槸鎸囧湅(gu贸)瀹舵暀鑲插拰琛�(w猫i)鐢熻鏀块儴闁€(m茅n)瑾�(r猫n)鍙殑姝ｈ(gu墨)闄㈡牎鐣㈡キ(y猫)瀛�(xu茅)姝锋垨?q奴)W浣�銆傚伐浣滃勾闄愯▓(j矛)绠楃殑鎴鏃ユ湡鐐鸿€冭│鍫�(b脿o)鍚嶅勾搴︾殑鐣�(d膩ng)骞村勾搴�锛屽牨(b脿o)鍚嶅弮鍔�2014骞村害濠︾敘(ch菐n)绉戜富娌婚啱(y墨)甯€冭│鐨勪汉鍝�锛屽叾瀛�(xu茅)姝峰彇寰楁棩鏈熷拰寰炰簨鏈皥妤�(y猫)宸ヤ綔骞撮檺鍧囨埅姝�2013骞�12鏈�31鏃ャ€�

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銆€銆€鏈夐棞(gu膩n)瑾�(shu艒)鏄庯細

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銆€銆€2銆佸牨(b脿o)鍚嶅弮鍔�?j矛)D鐢�(ch菐n)绉戜富娌婚啱(y墨)甯硣鏍艰€冭│浜哄摗锛屽牨(b脿o)鍚嶆浠朵腑鏈夐棞(gu膩n)瀛�(xu茅)姝风殑瑕佹眰锛屾槸鎸囧湅(gu贸)瀹舵壙瑾�(r猫n)鐨勫湅(gu贸)姘戞暀鑲插(xu茅)姝�锛涙湁闂�(gu膩n)宸ヤ綔骞撮檺鐨勮姹�锛屾槸鎸囧彇寰椾笂杩板(xu茅)姝峰墠鍚庡緸浜嬫湰灏堟キ(y猫)宸ヤ綔鏅�(sh铆)闁撶殑绺藉拰銆傚伐浣滃勾闄愯▓(j矛)绠楁埅姝㈠埌鑰冭│鍫�(b脿o)鍚嶅勾搴︾殑鐣�(d膩ng)骞村勾搴�銆�

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銆€銆€渚嬮锛氭偅鑰呯敺锛�66姝�銆傚洜鍡滅潯銆佹剰璀�(sh铆)妯＄硦4灏忔檪(sh铆)锛屽苟鍏╂鎶芥悙鍚庢槒杩蜂締(l谩i)闄㈡€ヨê銆傝繎1鍛ㄥ洜鍙楁都鍚庣櫦(f膩)鐔�銆佸挸鍡�锛屽埌鐣�(d膩ng)?sh霉)鍖(w猫i)鐢熼櫌閫�(j矛n)琛岄潨鑴堣几娉ㄨ憽钀勭硸娑插強鑲屾敞鎱跺ぇ闇夌礌绛夋不鐧�锛�3澶╁悗锛屽嚭鐝�(xi脿n)涔忓姏銆佸彛骞�銆佸椋插灏跨瓑鐧ョ媭骞舵棩婕稿姞鍔囷紝閬備締(l谩i)闄㈠氨瑷�銆傞珨鏍兼鏌ワ細T 38.8鈩冿紝P 108娆�/鍒�锛孊P 150/75mmHg锛�20/10kPa锛�銆傝偉鑳栭珨褰�锛屽攪鑸屽共鐕�锛岀毊鑶氬綀鎬у樊锛岀劇(w煤)闈㈢櫛楂斿緛锛岄牳鐒�(w煤)鎶垫姉銆傚乏涓嬭偤鍙仦婵�?闊炽€�

銆€銆€鍟�(w猫n)椤�1锛氭€ヨê鎳�(y墨ng)棣栧厛閲嶉粸(di菐n)妾㈡煡鐨勯爡(xi脿ng)鐩寘鎷�

銆€銆€1.琛€娓呴墍銆侀垑銆佹隘銆侀垼

銆€銆€2.鑵扮┛鑵﹁剨娑叉鏌�

銆€銆€3.琛€?d煤)澶ユ不?/P>

銆€銆€4.灏跨硸

銆€銆€5.琛€鑴�

銆€銆€6.琛€绯�

銆€銆€鎻愮ず锛氳閴€3.7mmol/L锛岃閳�156mmol/L锛岃姘�110mmol/L锛岃閳�2.5mmol/L.琛€绯�38.8mmol/L锛屽翱绯栵紙++++锛�銆傝閰紙-锛�锛屽翱閰�銆侫B 23mmol/L锛孴CO₂ 26mmol/L锛孊E -2锛�8mmol/L锛孲aO₂ 0.92锛岃婕挎徊閫忓358mmol/L.

銆€銆€鍟�(w猫n)椤�2锛氱洰鍓嶇殑鎬ヨê瑷烘柗鏄�

銆€銆€1.閲嶅害鏄忚糠

銆€銆€2.鑵﹁绠℃剰澶�

銆€銆€3.绯栧翱鐥呴叜鐧ラ吀涓瘨鏄忚糠

銆€銆€4.绯栧翱鐥呬钩閰告€ч吀涓瘨鏄忚糠

銆€銆€5.绯栧翱鐥呴珮婊叉€х劇(w煤)閰櫏鎬ф槒杩�

銆€銆€6.闈炶儼宄剁礌渚濊炒鍨嬶紙鈪″瀷锛夌硸灏跨梾

銆€銆€鍟�(w猫n)椤�3锛氭€ヨê铏曠悊鎺柦鍖呮嫭

銆€銆€1.闈滆剤杓告敞5锛呰憽钀勭硸娑�

銆€銆€2.闈滆剤杓告敞5锛匩aHCO₃娑�

銆€銆€3.闈滆剤杓告敞0.45锛呮隘鍖栭垑娑叉垨0.9锛呮隘鍖栭垑娑�

銆€銆€4.闈滆剤杓告敞1.87锛呬钩閰搁垑娑�

銆€銆€5.鎳�(y墨ng)鐢�20锛呯敇闇查唶鑴按

銆€銆€6.鐨笅娉ㄥ皠姝ｈ(gu墨)鑳板扯绱�

銆€銆€鎻愮ず锛氶潨鑴堟淮娉ㄦ瑕�(gu墨)鑳板扯绱�8鍠綅锛屽京(f霉)鏌ヨ閴€3.0mmol/L锛岃閳�150mmol/L锛岃绯�32.4mmol/L锛岃婕挎徊閫忓328mmol/L.鎮ｈ€呯1灏忔檪(sh铆)闈滆剤瑁�(b菙)0.45%姘寲閳夋恫鍙�0.9锛呮隘鍖栭垑娑�1000ml.琛€澹�135/60mmHg锛�18/8kPa锛�銆�

銆€銆€鍟�(w猫n)椤�4锛氱洰鍓嶆纰虹殑铏曠悊鎺柦鍖呮嫭

銆€銆€1.闈滆剤瑁�(b菙)閴€

銆€銆€2.绻肩簩(x霉)闈滄淮0.45锛呮隘鍖栭垑娑�

銆€銆€3.闈滆剤杓告敞5锛呰憽钀勭硸娑�

銆€銆€4.鍙潨鑴堣几鍏ヨ婕挎垨鍏ㄨ

銆€銆€5.鍙潨鑴堣几鍏�25锛呬汉楂旂櫧铔嬬櫧

銆€銆€6.绻肩簩(x霉)姣忓皬鏅�(sh铆)闈滆剤婊存敞姝ｈ(gu墨)鑳板扯绱�4锝�6鍠綅

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銆€銆€鍟�(w猫n)椤�5锛氱洰鍓嶆噳(y墨ng)閲囧彇鐨勮檿鐞嗘帾鏂藉寘鎷�

銆€銆€1.鎳�(y墨ng)鐢ㄦ姉鐢熺礌

銆€銆€2.绻肩簩(x霉)闈滆剤瑁�(b菙)閴€

銆€銆€3.闈滆剤杓告敞10锛呰憽钀勭硸娑�

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銆€銆€5.榧撳嫷(l矛)鎮ｈ€呴２姘撮€�(j矛n)椋�

銆€銆€6.绻肩簩(x霉)闈滆剤婊存敞鑳板扯绱犱互浣胯绯栭檷鑷虫甯歌寖鍦�

銆€銆€鎻愮ず锛氱稉(j墨ng)涓婅堪铏曠悊鍏╁ぉ锛屾偅鑰呭凡鑳介€�(j矛n)鍗婃祦璩�(zh矛)椋查锛屽皻鏈夊挸鍡�銆佺棸澶氶粌榛忋€傞珨婧�37鈩冿綖38.2鈩�銆傚京(f霉)鏌ョ┖鑵硅绯�14.8mmol/L.

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銆€銆€2.鐨笅娉ㄥ皠涓晥鑳板扯绱犳帶鍒惰绯�

銆€銆€3.鎸夌硸灏跨梾瑕佹眰鎺у埗椋查

銆€銆€4.绲︿簣纾鸿劜椤�(l猫i)鍙ｆ湇闄嶈绯栬棩娌荤檪

銆€銆€5.绲︿簣闆欒儘椤�(l猫i)鍙ｆ湇闄嶈绯栬棩娌荤檪

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銆€銆€7.绻肩簩(x霉)鎳�(y墨ng)鐢ㄦ姉鐢熺礌

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