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患儿贺×,女,12岁,于1985年5月3日晚食存放三天的人工培植凤尾菇(炒熟后已连吃3天),同餐者有家人及邻居十人。4小时后,患儿觉颈部发痒并恶心,呕吐一次,随即意识丧失。当即急诊送我院。体检:神清,精神差,血压测不到,脉搏不能触及。口唇肿脓,颈部有出血疹,四肢厥冷。心率104次/分,心音低钝,律齐。呼吸20次/分,肺部无干湿罗音。腹软,全腹有不固定性轻压痛,肝脾未触及,肠鸣音正常。考虑为过敏性休克,用地塞米松5mg 肌注,5％低分子右旋糖酐100ml 快速静推后,血压恢复到90/60mmHg,心音较前有力,脉搏仍细弱。查血常规:血红蛋白12.5g/dl红细胞435万,白细胞28300,中性88％,淋巴12％。两小时后血压复又降至80/40mmHg.用基础钠液300ml 快速静滴并继续应用10％葡萄糖500ml,内加氯霉素1g,地塞米松5mg,
Children × ×, female, 12 years old, on May 3, 1985 evening storage of three days of artificial cultivation of Pleurotus (fry has been eating three days), the same family of ten people and their neighbors. After 4 hours, the child felt itchy and nauseous neck, vomiting once, then loss of consciousness. Immediate emergency sent to our hospital. Physical examination: God clear, poor spirit, blood pressure can not be measured, pulse can not touch. Pus lip pus, neck bleeding, rashes limbs. Heart rate 104 beats / min, heart sound low blunt, law Qi. Breathing 20 beats / min, lungs without dry rales. Abdomen soft, the whole abdomen is not fixed light tenderness, liver and spleen not touched, bowel sounds normal. Considered as anaphylactic shock, dexamethasone 5mg intramuscular injection, 5% low molecular weight dextran 100ml rapid static push, the blood pressure returned to 90 / 60mmHg, the heart sound more powerful, the pulse is still weak. Check the blood routine: hemoglobin 12.5g / dl 43.5 million red blood cells, white blood cells 28,300, 88% neutral, lymphatic 12%. Two hours later, the blood pressure reduced to 80 / 40mmHg. With basic sodium 300ml rapid intravenous infusion and continue to use 10% glucose 500ml, add chloramphenicol 1g, dexamethasone 5mg,