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水中毒可引起一时性神经功能障碍包括精神错乱、头痛、昏迷及惊厥,但致死不多见。早期报道的一些病例是医源性的,大多是精神性的。本文首次报告1例因意外的水中毒而致死。患者女,40岁。精神错乱、语无伦次急诊。血压150/80mmHg,心率88/min,律齐,余未见异常。不久出现1次短暂的癫痫大发作,其后75分钟内血压升到220/80mmHg,脉搏48/min,呼吸的深度和节律不规则,双瞳散大,瞬眼运动尚存,咽反射存在,压迫胸骨和疼痛刺激无反应。全身反射亢进,但未引出跖反射。考虑颅压增高形成脑幕疝和脑干上部变形。于是静脉滴注了高渗甘露醇,并予插管、通气。随后又注射了氟美松。住院时血钠111mEq/L,钾3.1mEq/L,重碳酸盐16mEq/L,尿素3.0mEq/L(18.1mg/d1),血糖9.8mEq/L。患者是由于误饮了少量家中存放的稀释漂白粉液后大量饮水,约15升,甚至开始反复呕吐时,还在坚持喝水。2小时后精神错乱入院,因其它情况一直很
Water poisoning can cause temporary neurological dysfunction including insanity, headache, coma and convulsions, but death is rare. Some of the earlier cases reported were iatrogenic, mostly psychotic. This article first reported 1 case of death caused by accidental water poisoning. Female patient, 40 years old. Insanity, incoherent emergency. Blood pressure 150 / 80mmHg, heart rate 88 / min, law Qi, I did not see abnormalities. Shortly after the onset of a brief epileptic seizures, 75 minutes after the blood pressure rose to 220 / 80mmHg, pulse 48 / min, the depth of breathing and rhythm irregularities, double pupil, transient eye movement survived, pharyngeal reflex exists, Oppression of the sternal and painful stimuli no response. Hyperreflexia, but did not lead to plantar reflex. Consider increased intracranial pressure to form the brain herniation and upper brain stem deformation. So intravenous infusion of hypertonic mannitol, and to intubation, ventilation. And then injected with dexamethasone. Hospital sodium sodium 111mEq / L, potassium 3.1mEq / L, bicarbonate 16mEq / L, urea 3.0mEq / L (18.1mg / d1), blood glucose 9.8mEq / L. The patient is due to a small amount of misuse after drinking a small amount of diluted stored in the home after drinking plenty of liquid bleaching fluid, about 15 liters, and even began to vomit repeatedly, still insist on drinking water. Insomnia hospitalized after 2 hours, because of other things have been very