淡水溺水致急性溶血一例报道  

A Case Report of Acute Hemolysis Caused by Freshwater Drowning

作　　者：王林恒[1] 颜晓佳[1] 陈叶 WANG Linheng;YAN Xiaojia;CHEN Ye(Qijiang District People's Hospital,Chongqing 401420,China)

机构地区：[1]重庆市綦江区人民医院,重庆401420

出　　处：《大医生》2020年第24期107-109,共3页Doctor

摘　　要：本文主要对淡水溺水后患者出现急性溶血的治疗思路进行总结。选取重庆市綦江区人民医院2013年8月19日收治的1例淡水溺水患者,该患者溺水10 min后被他人救起,患者出现呼吸困难、心悸,伴咳粉红色泡沫痰,未予特殊处理,急入重庆市綦江区人民医院,对其入院查体,检测体温、脉搏、呼吸、血样、血氧饱和度、瞳孔情况以及患者的身体状况,通过神经系统查体,了解患者的四肢肌张力、呼吸困难情况,利用胸部CT,对患者的双肺情况进行观察,利用血气分析仪检查患者的各项血气指标。然后以以上检查结果为诊疗根据,诊断为溺水、Ⅰ型呼吸衰竭、吸入性肺炎以及急性肺水肿,然后展开有效的治疗,治疗途中患者频繁咳嗽,咳出的痰液多为粉红色泡沫状,同时发生呕吐,2013年8月20日,巩膜轻度黄染,尿液呈淡黄色,临床考虑患者为溶血,然后再次展开对症治疗,经7 d住院疗养,成功出院。经过本次淡水溺水患者的急救过程,研究发现患者出现淡水溺水后,其水电解质会发生失衡,血小板水平异常,患者出现急性溶血等其他并发症的概率较高,对患者的生命安全造成了极大的威胁。每天对本次收治的淡水溺水患者的各项指标进行密切观察,有效防止患者出现病变,然后根据患者的疾病变化情况,及时处理各种不良反应以及突发情况,进而展开针对性治疗,可以使患者的生命得到保障。This paper mainly summarizes the treatment of acute hemolysis in patients with freshwater drowning.1 patients with fresh water drowning were treated in Qijiang District People's Hospital on August 19,2013.They were rescued by others after drowning for 10 minutes.Patients suffered from dyspnea,palpitations,cough and pink phlegm sputum.They were not treated with special treatment.They were rushed to Qijiang District People's Hospital.They were admitted to hospital for examination,and their body temperature,pulse,breath,blood sample,blood oxygen saturation and pupil condition were detected.And the patient's physical condition,through the nervous system examination,to understand the patient's limb muscle tension,dyspnea,the use of chest CT,to observe the patient's double lung condition,the use of blood gas analyzer to check the patient's blood gas indicators.Then,based on the above findings,four cases were diagnosed as drowning,respiratory failure,aspiration pneumonia and acute pulmonary edema.Then effective treatment was carried out.The cough sputum was mostly pink foam in the course of treatment.Vomiting occurred at the same time.On August 20,2013,the sclera was slightly yellow and the urine was pale yellow.After 7 days of convalescence,the patient was discharged successfully.After the first aid process of patients with fresh water drowning,the study found that after patients with fresh water drowning,the water electrolyte imbalance,abnormal platelet levels,the probability of acute hemolysis and other complications is high,which poses a great threat to the life safety of patients.In the clinical every day to closely observe the indicators of patients,effectively prevent patients from pathological changes,and then according to the changes of patients'disease,timely deal with all kinds of adverse reactions and emergencies,and then carry out targeted treatment,can ensure the life of patients.

关 键 词：淡水溺水 急性溶血 治疗体会 

分 类 号：R47[医药卫生—护理学]