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患者女性,21岁,学生。因吃鱼被鱼刺刺伤咽部,吐血2小时于1996年10月21日到我院耳鼻喉科就诊。检查发现:咽后壁、悬雍垂多处点状出血,未见异物。间接喉镜下也未见异物。查血:WBC16.0×10~9/L,N 0.83,L 0.17。诊断:1、咽部挫伤,2、食道异物?由于血象高,给10%葡萄糖,500毫升加青霉素640万单位静滴(青霉素皮试阴性后)。当日输液无不良反应,咽部疼痛渐减轻,出血已停止,能进流质饮食。第二天仍按上述医嘱执行。当输液1小时后,患者突然述头晕、心慌、胸闷,转即晕倒在地(坐位输液)。当即查体:神志不清,BP 10/7kPa,P 46次/分。立即停止青霉素滴注,按青霉素过敏性休克处理。给肾上腺素1mg即刻肌肉注射,吸氧,更换液体,给5%葡萄糖盐水500毫升加多巴胺20mg,阿拉明10mg。急请
Patient female, 21 years old, student. Due to eating fish was stabbed throat, spit blood 2 hours in October 21, 1996 to our hospital otolaryngology clinic. Examination found: pharyngeal wall, uvula many punctate bleeding, no foreign body. Indirect laryngoscopy also showed no foreign body. Check the blood: WBC16.0 × 10 ~ 9 / L, N 0.83, L 0.17. Diagnosis: 1, pharyngeal contusion, 2, esophageal foreign body? Due to high blood, to 10% glucose, 500 ml plus penicillin 640 million units of intravenous infusion (penicillin skin test negative). The day of infusion no adverse reactions, pharyngeal pain gradually reduced, bleeding has stopped, into the liquid diet. The next day still according to the doctor’s order execution. When the infusion 1 hour later, the patient suddenly dizzy, palpitation, chest tightness, turn fainted (sitting infusion). Immediate examination: unconscious, BP 10 / 7kPa, P 46 beats / min. Immediately stop penicillin infusion, according to penicillin anaphylactic shock treatment. Give 1 mg of epinephrine for immediate intramuscular injections, oxygen, replace fluid, add 500 mL of 5% dextrose in saline to 20 mg of dopamine and alamin 10 mg. Urgent please