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患者,男,47岁.因精神异常20余年于87年12月18日入院,诊断为分裂——情感性精神病.既往体健,入院体格检查和实验室检查正常.给碳酸锂1.5g/d和氟哌啶醇30mg/d治疗,3天后出现发热,体温38℃,并有严重的吞咽困难,不能进食,言语动作减少伴有两手细颤.随即减少药量,但副反应不见减轻,次日出现意识障碍,意识处于朦胧状态,表情茫然,人物定向障碍,答非所问,反应迟纯,动作迟缓,步态不稳,大汗淋漓,烦燥不安,检查发现四肢肌张力呈齿轮样增高,并有粗大震颤.四肢腱反射活跃,病理反射未引出.实验室检查:WBC11.6×10~9/LN90%,L10%,血锂0.7mmol/l.EEG,EKG,胸透均正常.诊断为恶性综合征.停用氟哌啶醇和碳酸锂;给输液,促进药物排泄及补充生理需要量和保持电解质平衡;加用乙
Patient, male, 47 years old. Mental abnormalities were diagnosed as schizoaffective psychosis for more than 20 years on December 18, 1987. Previous physical examination, physical examination and laboratory tests were normal. Lithium carbonate 1.5 g / d And haloperidol 30mg / d treatment, 3 days after the fever, body temperature 38 ℃, and severe dysphagia, can not eat, verbal movements accompanied by reduction of both hands tremor .And then reduce the dose, but the side effects were not alleviated, times Day awareness of obstruction, consciousness in a dim state, blank expression, character orientation disorders, non-questioning, reaction delay pure, slow movements, unsteady gait, sweating, irritability, check the limb muscle tension was gear-like and There was a great tremor.Flexus tendon reflexes, pathological reflex did not lead.Laboratory examination: WBC11.6 × 10 ~ 9 / LN90%, L10%, blood lithium 0.7mmol / l.EEG, EKG, chest through the normal diagnosis of Malignant syndrome. Disable haloperidol and lithium carbonate; to infusion, to promote drug excretion and physiological needs and to maintain electrolyte balance; add B