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患者,男,48岁.因偶发室性早搏自服慢心律50片(50mg/片)10min后感头晕、心前区不适,继之神志不清,遂于发现症状的30min急诊入院.体检:T36.8℃,P66次/分,R16次/分,BP18/12kPa.神志不清,烦躁不安,双眼上翻;双侧瞳孔等大等圆约3mm,对光反射灵敏,颈软,两肺正常.心界大小正常,心音弱,心率66次/分,10min后降至50次/分,律齐,无杂音,腹部无异常.四肢肌张力增高.病理反射(一).血常规正常,血钾、钙、氯均正常,血钠127.1mmol/L.ECG示窦性心律,心率100次/分(用阿托品后).入院后立即清水洗胃,25%硫酸镁导泻,吸氧,肌注阿托品1mg,安定5mg,静注能量合剂、维生素C、地塞米粉等治疗,3h后神志清醒,诉头晕、心前区不适,心脏听诊及复查心电图均无异常.心脏三位片示心脏大小形态正常、肝、肾功能无异常,继给能量合剂、维生素C治疗,住院第7天心电图发现偶
Patients, male, 48 years old due to occasional ventricular premature beats slow heart rate 50 (50mg / film) 10min after feeling dizzy, precordial discomfort, followed by delirium, then found the symptoms of 30min emergency admission. Physical examination: T36.8 ℃, P66 beats / min, R16 beats / min, BP18 / 12kPa. Unconsciousness, restlessness, eyes upturned; bilateral pupil and other large round about 3mm, sensitive to light reflex, neck soft, Normal heart size normal, weak heart sounds, heart rate 66 beats / min, 10 min after the drop to 50 beats / min, law Qi, no noise, no abnormal abdomen. Extremities muscle tone increased. Pathological reflexes (a) Serum potassium, calcium, chlorine were normal, serum sodium 127.1mmol / L. ECG showed sinus rhythm, heart rate 100 beats / min (after atropine.) Immediately after admission to clean water gastric lavage, 25% magnesium sulfate catharsis, Intramuscular injection of atropine 1mg, stability and 5mg, intravenous injection of energy mixture, vitamin C, dexamethasone and other treatment, 3h after conscious, v. Dizziness, precordial discomfort, cardiac auscultation and review of ECG were normal. Normal size and shape, no abnormal liver and kidney function, followed by energy mixture, vitamin C treatment, hospital 7 days ECG found even