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患儿,女,8日龄。因皮肤接触甲胺磷农药5 h入院。第1胎第1产,足月顺产。其母因故自服甲胺磷(具体量不详),服后呕吐物污染患儿颈部、胸部皮肤及衣服,约1 h后其母抢救无效死亡,患儿呕吐1次白色泡沫状粘液,带很浓蒜臭味,当地医院肌注阿托品0.15mg后转来本院。体检:体温36℃,呼吸38次/min,脉博102次/min,血压8.0/6.3kPa,体重2680g,面色苍白,精神萎糜,口鼻腔呼出带蒜臭味气体,有少量粘液状分泌物,瞳孔缩小似针尖样,心音中强,心率102次/min,律齐,两肺呼吸音粗,未闻及哕音,腹软,肝脾不大,四肢肌张力偏低,可见微小颤动。实验室检查:血红蛋白171 g/L,白细胞数13.9×10~9/L,中性粒细胞0.72,淋巴细胞0.28,血小板数23.4×10~9/L。血胆碱酯酶活力
Children, women, 8 days old. Methotrexate pesticide due to skin contact 5 h admission. The first birth of the first child, full-term delivery. The mother due to self-meticlophos (specific amount unknown), after serving vomit contaminated children’s neck, chest skin and clothing, about 1 h after the mother died of an invalid, vomiting in children with a white foamy mucus, With a strong garlic smell, local hospital intramuscular injection of atropine 0.15mg transferred to the hospital. Physical examination: body temperature 36 ℃, breathing 38 times / min, Pulse 102 times / min, blood pressure 8.0 / 6.3kPa, weight 2680g, pale, spiritual wilt, oral and nasal exhaled garlic odor gas, a small amount of mucus secretions , Miosis-like tip-like, strong heart sound, heart rate 102 beats / min, law Qi, two lungs sound rough tone, no smell and 哕 sound, abdominal soft, small spleen and liver, limb muscle tension is low, showing slight tremor. Laboratory tests: hemoglobin 171 g / L, the number of white blood cells 13.9 × 10 ~ 9 / L, 0.72 neutrophils, lymphocytes 0.28, platelet count 23.4 × 10 ~ 9 / L. Blood cholinesterase activity