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患者女性,31岁,因生气后,于2005年7月1日约17:00左右自服“氯氮平”100片(2500 mg),约8 h 后,被家人发现。患者全身大汗,流诞,气急,言语不清,呼之不应,躁动不安,于02:40时急送我院抢救。既往患“抑郁症”1年余,长期服用“安定片”治疗。查体:血压106/62 mmHg;浅昏迷,双侧瞳孔直径1.5 mm,等大等圆,光反射迟钝。心率120次/min,呼吸浅快,28次/min,双肺布满湿性罗音。腹平软,肠鸣音亢进,膀胱充盈且有少量遗尿。四肢肌张力降低,双侧巴彬斯基征阳性。急诊给予10000 ml 左右液体洗胃,同时给予吸氧、吸痰、保持呼吸道通畅,导尿800 ml,促进代谢、脱水、催醒、保护胃黏膜及补液治疗。急查血常规:WBC 17.9×10~9/L,N 92.4%,L5.0%,Hb 154 g/L。心电图:窦性心动过速,125次/min,ST-T 改变。04:00时,患者躁动不安,口唇苍白,呕鲜血约100
The female patient, 31 years old, was found by his family about 8 hours after becoming angry at about 17:00 on July 1, 2005 since serving “clozapine” 100 tablets (2500 mg). Patient sweating, blessing, shortness of breath, unclear speech, call should not, restless, at 02:40 when the emergency hospital sent to our rescue. Previously suffering from “Depression ” more than 1 year, long-term use “stability tablets ” treatment. Physical examination: blood pressure 106/62 mmHg; shallow coma, bilateral pupil diameter 1.5 mm, such as large circle, light reflex slow. Heart rate 120 beats / min, shallow breathing fast, 28 beats / min, lungs full of wet rales. Abdomen soft, bowel sounds hyperthyroidism, bladder filling and a small amount of enuresis. Limb muscle tension decreased, both sides Babinski sign positive. Emergency given about gastric lavage 10000ml, while giving oxygen, suction, keep the airway clear, catheterization 800 ml, promote metabolism, dehydration, wake up, protect the gastric mucosa and rehydration therapy. Urgent blood test: WBC 17.9 × 10 ~ 9 / L, N 92.4%, L5.0%, Hb 154 g / L. ECG: sinus tachycardia, 125 beats / min, ST-T changes. 04:00, the patient restless, pale lips, vomit blood about 100