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患者,男,30岁。于入院当天下午5时起在烈日下喷1605农药约持续1小时,晚饭后8时许感恶心,呕吐胃内容物数次,伴大汗淋漓、头昏心悸、乏力而急诊入院。查体:T36℃、R30次/min、P120次/min、BP16/10kPa,神志模糊,大汗,双瞳孔明显缩小,直径约1mm,颈软,呼吸急促,无紫绀,双肺呼吸音粗糙,肺底可闻及少量水泡音。心脏听诊:心律紊乱,频发早搏约15次/min,心率速,心音有力。腹软无压痛,肝脾不肿大,肠鸣音正常。NS(-)。既往无心脏及其它特殊病史。急诊ECG揭示:频发多源室性早搏。诊断:中度有机磷(1605)中毒并频发多源室早。立即给予阿托品20mg静注、利多卡因100mg静注,同时吸氧、输液等支持治疗。用药后听诊室早明显减少
Patient, male, 30 years old. On the day of admission at 5 pm on the hot day spray 1605 pesticide about 1 hour after dinner, 8:00 feel nausea, vomiting stomach contents several times, with sweating, dizziness, palpitations, fatigue and emergency admission. Examination: T36 ℃, R30 times / min, P120 times / min, BP16 / 10kPa, ambiguous, sweating, double pupil was significantly reduced diameter of about 1mm, soft neck, shortness of breath, no cyanosis, The bottom of the lung can be heard and a small amount of blisters sound. Cardiac auscultation: heart rhythm disorders, frequent premature beats about 15 times / min, heart rate, strong heart sounds. Abdominal tenderness without tenderness, liver and spleen is not enlarged, normal bowel sounds. NS (-). Past no heart and other special medical history. Emergency ECG revealed: frequent multi-source premature ventricular contractions. Diagnosis: Moderate organophosphate (1605) poisoning and frequent multi-source room early. Immediately given atropine 20mg intravenous injection of lidocaine 100mg intravenous infusion, while oxygen, infusion and other supportive treatment. Auscultation early after treatment significantly reduced