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男20岁。与人争吵生气后服安定75mg、冬眠灵250 mg,昏迷,口吐白沫,瞳孔针尖样大,呼吸困难。当地卫生院误诊为有机磷农药中毒,经洗胃、输液、静注阿托品(共用300 mg)无好转,15 小时后转入我院。查体:体温不升,脉搏110次/分,呼吸25次/分,血压9/6kPa,浅昏迷状态,双瞳孔等大,直径7mm,口唇紫绀,双肺满布干湿性罗音,心率110次/分,律齐,无杂音。腹部无异常,四肢凉,病理征阴性。诊断:安定和冬眠灵中毒,非心源性肺水肿。给予输液,静滴多巴胺,阿拉明,氟美松,654—2,美解眠,间断应用速尿,西地兰等药物。同时,气管插管,人工呼吸机间歇高频喷射通气治疗。入院25小时后神志转清,住院8天痊愈出院。
Male 20 years old. Quarrel with people angry after service stability 75mg, winter sleep spirit 250 mg, coma, foaming at the mouth, pupil needle-like big, dyspnea. Local hospitals misdiagnosed as organophosphorus pesticide poisoning, gastric lavage, infusion, intravenous atropine (300 mg sharing) no improvement, 15 hours later transferred to our hospital. Physical examination: body temperature does not rise, pulse 110 beats / min, breathing 25 beats / min, blood pressure 9 / 6kPa, shallow coma, double pupil and other large diameter 7mm, lips cyanosis, lungs covered with wet and dry rales, heart rate 110 times / min, law Qi, no noise. No abnormal abdomen, cold limbs, pathology sign negative. Diagnosis: stability and winter sleep poisoning, non-cardiogenic pulmonary edema. Give infusion, intravenous infusion of dopamine, Alamin, dexamethasone, 654-2, the US solution of sleep, intermittent furosemide, cedilan and other drugs. At the same time, endotracheal intubation, respirator intermittent high-frequency jet ventilation treatment. After 25 hours admitted to consciousness clear, hospitalized 8 days cured.