论文部分内容阅读
患者,男,31岁。因喷散杀虫脒和甲硫磷农药而感头晕,在外院诊为有机磷农药中毒,于3小时内静注阿托品120mg,先烦燥不安,继之昏迷,于1996年6月4日转来我院急诊科,以急性有机磷农药中毒并阿托品中毒收住入院。既往无特殊病史。体检:患者呈深度昏迷状态,双侧瞳孔散大,直径8mm大小,对光反射消失,眼底视乳头边缘模糊,两肺呼吸音粗,未闻及干湿罗音,心率57次/分,节律齐,双下肢锥体束征可疑阳性。心电图示:P波Ⅰ,avl,V_5呈双峰,Ⅱ、Ⅲ,avF、V_1倒置,avR直立,V_3呈双向,P-R≥0.14”,QRS波群大致正常,心率57次/分,节律齐,胆硷脂酶45~v(试纸法正常值30～80~u),在心电监护下积极抢救昏迷,经用20％甘露醇250毫升加氟美松5mg静脉推注,每8小时一次,速尿40mg静脉
Patient, male, 31 years old. Due to the spread of chlordimeform and methylphenothion pesticide and feel dizzy, diagnosed as organophosphate pesticide poisoning in the hospital, intravenous injection of atropine 120mg within 3 hours, the first irritable, followed by coma, on June 4, 1996 turn To our hospital emergency department, acute organophosphorus pesticide poisoning and atropine poisoning admitted to hospital. No special medical history. Physical examination: The patient showed a deep coma, bilateral mydriasis, diameter 8mm size, the disappearance of light reflexes, blurred vision of the optic nerve end of the fundus, both lungs breath sounds coarse, no smell and wet and dry rales, heart rate 57 beats / min, rhythm Qi, both lower extremity pyramidal tract sign suspicious positive. ECG: P wave Ⅰ, avl, V_5 showed a bimodal, Ⅱ, Ⅲ, avF, V_1 inversion, avR upright, V_3 bidirectional, PR ≥ 0.14 ", QRS complex is generally normal, heart rate 57 beats / Cholesterol lipase 45 ~ v (test strip normal 30 ~ 80 ~ u), active rescue coma under ECG monitoring, with 20% mannitol 250ml plus mefloxacin 5mg intravenous injection, once every 8 hours, speed Urine 40mg vein