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临床资料王某,男,45岁,因受凉后出现咽痛、咳嗽、咳痰3天,于2006年3月28日门诊以“支气管炎”收治入院。入院后给予锋青扬静脉滴注,每日2次,每次2.0克,3天后病人咽痛、咳嗽、咳痰症状缓解。2006年4月2日9pm 病人外出进餐饮啤酒350ml 余,10pm 出现左侧心前区疼痛,伴心慌不适,查体T36.5℃,P112次/分,R25次/分,BP130/70mmHg。意识清楚,全身皮肤发红,双眼球结膜充血,呕吐一次为胃内容物。既往有饮酒史,每天饮白酒3两左右。本次住院期间除使用锋青扬静脉滴注及口服复方甘草合剂以外未使用其他药物,同时在一起饮酒的其他人员均未出现类似症状。处理低流量吸氧,行床边心电、血压监护。球结膜充血嘱病人卧床休息,必要时观察血象。心电图检查提示:(1)窦性心动过速;(2)Ⅱ、Ⅲ、avF 及 V_3～V_6 ST 段水平下移1mv。立即舌下含服消心痛10mg,建立静脉通道,静脉推注合贝爽10mg及肌肉注射止吐药,2小时后胸前区疼痛的症状有所缓解,未再呕吐,3小时后全身皮肤颜色转为正常,心肌酶谱及凝血功能正常。12:30 pm 查体 T36.8℃ P67次/分,R18次/分,BP110/70 mmHg,病情趋于稳定。
Clinical data Wang, male, 45 years old, due to cold after sore throat, cough, sputum for 3 days, on March 28, 2006 outpatient to “bronchitis ” admitted to hospital. Feng Qing Yang given intravenously after admission, 2 times a day, each 2.0 grams, 3 days after the patient sore throat, cough, sputum remission. April 2, 2006 9pm patients out of dining beer 350ml more than 10pm appeared on the left precordial pain, palpitation discomfort, physical examination T36.5 ℃, P112 beats / min, R25 beats / min, BP130 / 70mmHg. Consciousness, systemic redness, conjunctival hyperemia, vomiting once for the stomach contents. Past history of drinking, drink 3 or so white wine every day. During the hospital stay except for the use of Feng Qing Yang intravenous drip and oral compound licorice mixture other than the use of other drugs, while other people drinking together did not show any similar symptoms. Low-flow oxygen treatment, bedside ECG, blood pressure monitoring. Bulbar conjunctival congestion instruct patient bed rest, if necessary, observe the blood. ECG examination prompts: (1) sinus tachycardia; (2) Ⅱ, Ⅲ, avF and V_3 ~ V_6 ST segment level down 1mv. Immediately sublingual convulsive pain 10mg, the establishment of intravenous access, intravenous injection of co-Pui Shuang 10mg and intramuscular injection of anti-emetic drugs, 2 hours after chest pain relief symptoms, no further vomiting, 3 hours after the whole body skin color Turn to normal, myocardial enzymes and coagulation is normal. 12:30 pm examination T36.8 ℃ P67 beats / min, R18 beats / min, BP110 / 70 mmHg, the condition stabilized.