一、病例摘要女,45岁。因高烧,抽搐,昏迷3小时于1987年10月12日18时急就诊。患者前一天中午在高温下搬运货物,两次被雨淋,当晚感头昏,皮肤灼痛,多汗。次日上午头痛,腹痛,口干,多汗,多饮,肌注阿托品1支后汗少,腹痛缓解。下午因气急、胸闷、烦燥,高烧40℃再次就医,肌注安乃近、鲁米那钠各1支后症状缓解。于18时突然高烧,大汗淋漓,频繁抽搐,昏迷。体检,体温41.5℃,脉博26次/分,叹息样呼吸,血压测不到,瞳孔不等大,对光反射弱,肾迷状态。皮肤弹性差,呈Ⅱ°脱水征。心音微弱,心律不齐,两肺可闻湿性罗音。腹肌紧张,肝、脾未及。四肢呈强直痉挛状态,病理反射未引出,患者衣,裤、毛发全湿如洗。拟诊:中署高热,抽搐。经吸氧,补液,纠酸,补充 First, the case summary Female, 45 years old. Due to a high fever, convulsions, coma 3 hours at 18 o’clock on the October 12, 1987 urgent treatment. Patients at noon the day before the goods under high temperature, twice was the rain, the night feeling dizzy, burning skin, sweating. The next morning headache, abdominal pain, dry mouth, sweating, drinking, intramuscular injection of atropine after a small sweat, abdominal pain relief. Afternoon due to shortness of breath, chest tightness, irritability, high fever 40 ℃ to seek medical attention, intramuscular Annapurny, lilium sodium after a symptom? At 18:00 sudden high fever, sweating, frequent convulsions, coma. Physical examination, body temperature 41.5 ℃, pulse 26 times / min, sigh like breathing, blood pressure can not be measured, the pupil ranging from large, light reflection weak, kidney fans state. Poor skin elasticity, showed Ⅱ ° dehydration sign. Heart sounds weak, arrhythmia, both lungs can smell wet rales. Abdominal tension, liver, spleen and time. Limb was tonic spasticity, pathological reflex did not lead to the patient clothing, pants, hair, such as wet and dry. To be diagnosed: Department of heat, convulsions. After oxygen, fluid, correct acid, add