病例分享:32岁女性高血压猝死是怎么发生的?

2018-02-17 李青 天津市泰达医院 医学之声

32岁女性,中午在家洗衣服,洗了一会站立后突感剧烈头痛,随即晕倒,很快意识丧失,并出现呕吐。家人以为缓一缓就好,可等过了半小时发现病情越来越重,呼吸急促,才拨打的120。

32岁女性,中午在家洗衣服,洗了一会站立后突感剧烈头痛,随即晕倒,很快意识丧失,并出现呕吐。家人以为缓一缓就好,可等过了半小时发现病情越来越重,呼吸急促,才拨打的120。

患者13:00被送到医院急诊时呼吸微弱,意识丧失,瞳孔散大,血压255/199mmHg。5分钟后呼吸、心跳停止,血压测不到,最终抢救无效死亡。

患者体型消瘦,身高160cm,体重仅40kg。既往有肾炎病史,平时很少测血压,测过一次150/100mmHg左右,没有正规的检查治疗。产后11个月。其他病史不详。

分析死亡原因可能是脑血管畸形破裂出血,脑疝压迫呼吸心跳中枢,心搏骤停。

这又是一起高血压导致的悲剧。根据不完整的病历资料推测:

她最根本的病因在肾脏。原有慢性肾炎,肾性高血压,没有经过正规治疗和控制。长期的高血压导致脑血管瘤形成。而且怀孕加重了肾脏病,甚至可能出现了慢性肾功能衰竭,血压进一步升高,出现了恶性高血压。

此外,年轻人、慢性肾脏病、脑血管瘤,三个因素综合分析有可能是多囊肾。

快过年了,紧张、劳累,恶性升高的高血压导致脑血管瘤破裂,颅内大量出血,颅内压明显升高,引起脑疝,导致呼吸心跳骤停。

这位患者年仅32岁就突然离世,留下一个不满周岁的孩子,其情其景真让人唏嘘不已。患者本人及其家人诸多的失误,导致了悲剧分发生。

1、慢性肾脏病被忽视:各种原因导致的慢性肾脏病大都会出现高血压,高血压不控制又会加重肾脏病,血压会进一步升高,二者形成恶性循环。

2、长期的高血压,颅内某个发育不良的血管管壁在血压的作用下逐渐膨出形成血管瘤,血管瘤管壁越来越薄,某一时机在更高的血压作用下破裂出血。高血压患者如果有反复的头痛,应该进行脑血管造影等针对性检查。

3、怀孕对肾脏病的影响也被忽视,怀孕期间及生产后的身体状况没有认真对待。而且恶性高血压也不是一朝一夕发生的,此前没有及时控制。

4、最大的失误来自于家人,患者已经意识丧失了都没有及时的拨打急救电话,最后延误了治疗。

平时关注健康,有病早治疗,无论过什么节,身体最重要。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=289045, encodeId=68fd2890457a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 19 01:09:35 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288863, encodeId=bb0e288863ac, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 18 08:44:11 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288643, encodeId=a769288643fe, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Feb 17 09:19:43 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288613, encodeId=5ea828861373, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Feb 17 08:51:44 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288611, encodeId=53be28861188, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Feb 17 08:47:15 CST 2018, time=2018-02-17, status=1, ipAttribution=)]
    2018-02-19 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=289045, encodeId=68fd2890457a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 19 01:09:35 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288863, encodeId=bb0e288863ac, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 18 08:44:11 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288643, encodeId=a769288643fe, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Feb 17 09:19:43 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288613, encodeId=5ea828861373, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Feb 17 08:51:44 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288611, encodeId=53be28861188, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Feb 17 08:47:15 CST 2018, time=2018-02-17, status=1, ipAttribution=)]
    2018-02-18 lou.minghong

    学习了.谢谢分享!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=289045, encodeId=68fd2890457a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 19 01:09:35 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288863, encodeId=bb0e288863ac, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 18 08:44:11 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288643, encodeId=a769288643fe, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Feb 17 09:19:43 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288613, encodeId=5ea828861373, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Feb 17 08:51:44 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288611, encodeId=53be28861188, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Feb 17 08:47:15 CST 2018, time=2018-02-17, status=1, ipAttribution=)]
    2018-02-17 神功盖世

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=289045, encodeId=68fd2890457a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 19 01:09:35 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288863, encodeId=bb0e288863ac, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 18 08:44:11 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288643, encodeId=a769288643fe, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Feb 17 09:19:43 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288613, encodeId=5ea828861373, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Feb 17 08:51:44 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288611, encodeId=53be28861188, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Feb 17 08:47:15 CST 2018, time=2018-02-17, status=1, ipAttribution=)]
    2018-02-17 龙胆草

    学习谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=289045, encodeId=68fd2890457a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 19 01:09:35 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288863, encodeId=bb0e288863ac, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Sun Feb 18 08:44:11 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288643, encodeId=a769288643fe, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Feb 17 09:19:43 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288613, encodeId=5ea828861373, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Feb 17 08:51:44 CST 2018, time=2018-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288611, encodeId=53be28861188, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Feb 17 08:47:15 CST 2018, time=2018-02-17, status=1, ipAttribution=)]
    2018-02-17 医者仁心5538

    学习了

    0

相关资讯

Stroke:科学家们发现女性特有的中风风险因子

女性群体受中风的影响明显高于男性,它是美国境内导致女性死亡第三高的疾病。最近,来自BWH的研究者们找到了女性群体特有的中风风险因子,包括激素水平、激素疗法的影响、激素生育控制、怀孕以及月经来潮与绝经等等。相关结果发表在最近一期的《Stroke》杂志上。

JACC Cardiovasc Inte:新一代药物洗脱支架长度是否影响接受PCI女性的结局?

2018年1月,发表在《JACC Cardiovasc Interv》的一项由美国、法国、意大利、英国等国科学家进行的分析,考察了增加新一代药物洗脱支架长度对于接受PCI女性的3年临床结局的影响。

BMJ:偏头痛大幅增加主要心脑血管疾病风险

研究认为,偏头痛患者心肌梗死、缺血性卒中、出血性卒中、静脉血栓、房颤或房扑风险增加,偏头痛是重要的心脑血管疾病风险因素

Sci Rep:临床诊断盆腔器官脱垂的流行度和治疗方式分析

最近,有研究人员利用韩国索赔数据资料,评估了盆腔器官脱落的流行度,并且还评估了治疗的方式。韩国国民健康保险公司对大多数疾病支付医疗费用。研究中使用了2009-2015年的健康保险审查与全国住院患者样本评估服务(HIRA-NIS)。盆腔器官脱落通过诊断代码(N81.x)来确定。在HIRA-NIS 2009-2015数据库中的450万女性中,研究人员选择了10305名女性被选择且患有盆腔器官脱落,且盆

70年研究发现:聪慧女性绝经晚,有钱人生更美满

这是一项长达70年的研究:1947年3月,英国的研究人员对在一周内出生的5000多名孩子进行跟踪调查,每隔几年就记录一次他们的生理、经济和心理状况。70年间,项目几次面临被终结的命运,研究者也更替了四代。现在,他们成为世界上被研究得最透的一群人,所有的研究数据都成为科学史上最宝贵的财富,而研究仍在继续……

Hum Reprod:合理膳食助力女性接受辅助生殖治疗的结局

2018年1月,发表在《Hum Reprod.》的一项由美国科学家进行的研究,考察了血清ω-3脂肪酸对辅助生殖治疗结局的影响。