论文部分内容阅读
冯××男 35岁住院号874130。病人因咳嗽、咯痰10年余,咯血2小时于1987年8月28日入院。入院后给予止血对症治疗,咯血控制。病人1982年确诊肺结核,既往口服RFP45g(0.6/日)后,开始出现过敏反应,表现为寒战、发热及全身不适等,经催吐后症状缓解。随后间歇试服RFP(0.6/日)5次均出现上述反应。29日上午8时10分,在观察情况下,试投服INH0.4g,EMB1g,RFD0.3g(广东省江门市制药厂生产,批号870304)。20分钟后出现寒战、高热、胸闷、气紧等,继而烦躁不安,转入昏迷。查体:T41.7℃,R32次,P140次,Bp80/40mmHg;深昏迷,皮肤灼热,无皮疹;双侧瞳孔对称性缩小,对光反射消失,鼻翼煽动,口唇发绀;左肺听诊闻及湿性罗音,心脏无杂音,肝脾无异常;深浅反射消失,无病理反射征。拟诊过敏性休克。4小时后经肌注异丙嗪50mg、皮内注射肾上腺素1mg,静注地塞米松20mg、葡萄糖酸钙1g、氨茶碱2.5mg;
Feng XX male 35 years old hospital number 874,130. Patient cough, expectoration more than 10 years, 2 hours of hemoptysis on August 28, 1987 admitted. Give hemostasis symptomatic treatment after admission, hemoptysis control. Patients diagnosed with tuberculosis in 1982, previous oral RFP45g (0.6 / day), began to appear allergic reactions, manifested as chills, fever and general malaise, after emetic symptoms. This was followed by intermittent trials of RFP (0.6 / day) five times. At 8:10 on the 29th, in the case of observation, try to vote to take INH0.4g, EMB1g, RFD0.3g (Guangdong Jiangmen Pharmaceutical Factory production, batch number 870304). After 20 minutes chills, fever, chest tightness, tightness, etc., and then restless, into a coma. Examination: T41.7 ℃, R32 times, P140 times, Bp80 / 40mmHg; deep coma, skin burning, no rash; bilateral pupil symmetry reduced, disappeared light reflex, nose incitement, lips cyanosis; left lung auscultation and Humoral rales, heart no noise, no abnormal liver and spleen; depth reflex disappeared, no pathological reflex sign. To be diagnosed with anaphylactic shock. 4 hours after intramuscular injection of promethazine 50mg, intradermal injection of epinephrine 1mg, intravenous injection of dexamethasone 20mg, calcium gluconate 1g, aminophylline 2.5mg;