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患儿男,9岁,因淹溺后昏迷、气急、发绀4小时于1991年7月14日入院.落水约10余分钟,救起时无心跳及自主呼吸,他院抢救2～3小时后,仍昏迷不醒,遂来本院.体检;T39℃,R65次/分,BPO,脉细弱扪不清昏迷状态,面色青灰,全身紫绀,两瞳孔等大,0.3cm,光反射弱,呼吸急促,鼻掮,三凹征,阵阵憋气,颈静脉无怒张,心界稍扩大,HR180次/分,律齐,心音弱.两肺叩浊,布满水泡音.腹平软,肝肋下0.5cm,脾未及.实验室检查:血 Hb120g/L,WBC5×10~9/L,N 0.7,L 0.26,EO.04;血Na~+ 130mmol/L,K~+3.6mmol/L,CO_2CP13.4mmol/L.入院后予吸氧,静注速尿、西地兰、地塞米松、碳酸氢钠、2:1溶液及抗生素,同时选用654-2静注,20～100mg/次,5～10分钟1次.用药8次后病情未见明显好转,即试用阿托品治疗,开始5mg/次,最后加至20mg/次,5～15分钟1次,直接静注.用药8次后(总量60mg,历时1.5 ,小时),紫绀渐消失,气急减轻,憋气消失,瞳孔放大,HR慢至140次/分,心音增强,脉有力,血压升至12/gkPa,两肺水泡音消失,肝脾未及,尿潴留.即将阿托品减至 5mg/次,半小时1次,但1个半小时后,症状、体征复现,BP降至8/5kPa,HR180～190次/分,途加大阿托品剂量,缩短间隔时,每次从10mg加至50mg,5～15分钟1次,同时继续其它综合治疗措施.经阿托品反复注射32次,总剂量达665mg,历时
Children aged 9, drowning coma, shortness of breath, cyanosis 4 hours in hospital on July 14, 1991. Falling water for about 10 minutes, no heartbeat and spontaneous resuscitation, his hospital rescue 2 to 3 hours later T39 ℃, R65 beats / min, BPO, pulse weak palpable unconscious state, looking blue and gray, the whole body cyanosis, two pupil and other large, 0.3cm, light reflection weak, breathing Hypertrophic, epistaxis, three concave sign, bursts of breath, no jugular vein engorgement, heart slightly expanded, HR180 beats / min, law Qi, weak heart sounds. Rib 0.5cm, the spleen is not. Laboratory tests: Blood Hb120g / L, WBC5 × 10 ~ 9 / L, N 0.7, L 0.26, EO.04; L, CO_2CP13.4mmol / L. After admission to oxygen, intravenous furosemide, cedilanid, dexamethasone, sodium bicarbonate, 2: 1 solution and antibiotics, while the choice of 654-2 intravenous injection of 20 ~ 100mg / Times, 5 to 10 minutes 1. After medication 8 times the disease did not significantly improved, that trial of atropine treatment, start 5mg / times, and finally added to 20mg / time, 5 to 15 minutes 1, intravenous injection. After (total 60mg, lasted 1.5 hours), cyanosis gradually disappear, shortness of breath to reduce suffocation, pupil enlargement, HR slow to 140 beats / min, heart Sound enhancement, strong pulse, blood pressure rose to 12 / gkPa, the two lung vocal sounds disappear, liver and spleen and urine retention is about to atropine reduced to 5mg / time, half an hour 1, but 1 and a half hours later, the symptoms and signs BP, BP decreased to 8 / 5kPa, HR180 ~ 190 beats / min, en route to increase the dose of atropine, shorten the interval, each time from 10mg to 50mg, 5 to 15 minutes 1, while continuing the other comprehensive treatment. Atropine repeated injections 32 times, the total dose of 665mg, lasted