论文部分内容阅读
患者,女,27岁,住院号7270。因生气服异烟肼100片(10g)而呕吐、昏迷,20分钟后收我院急诊。既往无胃病及其它疾病史。查体:T36.4℃,P88次,R20次,BP14.6/11.4KPa。神志不清,全身皮肤无黄疸及出血,双侧瞳孔等大、圆形,直径4mm,对光反应迟钝。心率88次,律齐,心音清,双肺听诊正常。腹无异常,双膝反射减弱。Hb100g/L,RBC4.18×10~(12)/L,Cr88.4umol/L,BUN5.64mmol/L,CO_2-CP33.0mmol/L,心电图及尿常规正常。入院诊断:异烟肼急性中毒。予以洗胃、吸氧、大剂量维生素B6、烟酰胺、碱剂、脱水剂、神经细胞活化剂等综合治疗,出现阵发性躁动、抽搐予以止痉治疗。入院3小时,突然呕吐棕褐色液体约500ml,继之排黑色糊状粪便6～7次,量较多。患者面色苍白,口唇与肢端发绀,呼吸急促,四肢湿冷。BP6.66～7.98/5.32～
Patient, female, 27 years old, hospital number 7270. Due to anger with isoniazid 100 (10g) and vomiting, coma, 20 minutes after receipt of emergency hospital. No past history of stomach and other diseases. Physical examination: T36.4 ℃, P88 times, R20 times, BP14.6 / 11.4KPa. Confusion, no jaundice and bleeding in the whole body skin, bilateral pupils and other large, round, diameter 4mm, slow reaction to light. Heart rate 88 times, law Qi, heart sound clear, lung auscultation normal. Abdominal abnormalities, knee reflex decreased. Hb100g / L, RBC4.18 × 10-12 / L, Cr88.4umol / L, BUN5.64mmol / L, CO_2-CP33.0mmol / L, normal ECG and urine. Admission diagnosis: Isoniazid acute poisoning. To gastric lavage, oxygen, high-dose vitamin B6, nicotinamide, alkali agents, dehydration agents, nerve cell activators and other comprehensive treatment, paroxysmal agitation, convulsions to stop spasm treatment. Admission for 3 hours, suddenly vomited tan liquid about 500ml, followed by a row of black paste stool 6 to 7 times more. Patient pale, lips and extremities cyanosis, shortness of breath, cold limbs. BP6.66 ~ 7.98 / 5.32 ~