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患者,男,25岁,体重65kg,因背部突发性刀绞样疼痛伴头晕、胸闷、心慌4d入院,CT示Ⅰ型夹层动脉瘤,既往高血压病史5年。入院检查:血压(BP)200/100mmHg(1 kPa=7.5 mm Hg)、心率(HR)110次/min、脉搏血氧饱和度(SpO2)98% -99%、血常规、肾功能、胸部X线及动脉血气分析等未见异常。入院后口服地尔硫卓30 mg/次、奥美拉唑25 mg/次,巯甲丙脯酸12.5 mg/次,每天3次,静脉输注硝普钠(SNP)4.5～6 μg·kg-1·mm-1,控制BP在103/45-150/80 mm Hg之间,共10 d,总量5 310 mg。
The patient, male, 25 years old, weighing 65 kg, was admitted to the hospital with dizziness, chest tightness and palpitation on the back due to sudden knife-edge pain. The CT showed type I dissection aneurysm, with a history of 5 years. Admission examination: Blood pressure (BP) 200 / 100mmHg (1 kPa = 7.5 mm Hg), heart rate (HR) 110 beats / min, SpO2 98% -99%, blood, kidney function, Line and arterial blood gas analysis without exception. After oral administration of diltiazem 30 mg / time, omeprazole 25 mg / time, captopril 12.5 mg / time three times a day, intravenous sodium nitroprusside (SNP) 4.5 ~ 6 μg · kg-1 · mm-1, BP was controlled between 103 / 45-150 / 80 mm Hg for a total of 10 310 mg.