一、临床资料患者男性,12岁。生气后服农药呋喃丹(量不详),奔跑中跌入水中。伤后2小时入院。查体:KT35℃,P92次/分,BP10/6 KPa,R6次/分深昏迷(GSG3分),下颌式呼吸,四肢强直性抽搐,左额部明显肿胀,后枕部淤斑约 4×6cm左右。眼睑青紫,双侧瞳孔缩小(1mm),光反射消失,双眼球水平眼震。鼻腔及口腔有大量白色泡沫样液体,口唇发绀,颈强直。两肺湿性罗音,生理反射消失,双下肢病理反射阳性。诊断:呋喃丹中毒,原发性脑干损伤,淹溺、肺水肿,呼吸衰竭。入院后约5分钟呼吸停止,立即行气管内插管,清除呼吸道分泌物,应用自动人工呼吸机进行间断正压呼吸,持续吸氧,迅速建立循环通道,静脉滴入呼吸中枢兴奋剂、脱水剂、激素、抗菌素、保肝剂、硷 First, the clinical data Male patients, 12 years old. After serving pesticide carbofuran (an unknown amount), run into the water. 2 hours after injury admission. Examination: KT35 ℃, P92 / min, BP10 / 6 KPa, R6 times / min deep coma (GSG3 points), jaw breathing, tetanic twitching, left forehead was significantly swollen, posterior occipital ecchymosis about 4 × 6cm or so. Eyelid bruising, bilateral miosis (1mm), light reflex disappeared, eyes nystagmus level. Nasal and oral white foam-like liquid, lips cyanosis, neck stiffness. Two lung wet rales, physiological reflex disappeared, both lower extremities pathological reflex positive. Diagnosis: carbofuran poisoning, primary brain stem injury, drowning, pulmonary edema, respiratory failure. About 5 minutes after admission to stop breathing, immediately endotracheal intubation, removal of respiratory secretions, the use of automatic respiration for intermittent positive pressure breathing, sustained oxygen, the rapid establishment of a circulating channel, intravenous infusion of respiratory stimulants, dehydration agent , Hormones, antibiotics, hepatoprotective agents, alkaline