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患者张某某,女,56岁,3.5小时前吞服阿密替林2100mg 及硝基安定420mg。查体:T 3℃(腋),P112,R 24,BP 126/80,深昏迷,两侧瞳孔等大,直径3mm,光反应迟钝,心肺(-),肌张力弛缓,双侧肢体肌力0°,膝反射未叩出,病理反射(-),肝、肾功能正常,EKG 示窦性心动过速.人院后给予能量、美解眠等治疗,病情无好转,体温升至39.2℃(腋),脸面潮红,皮肤干燥。瞳孔直径4 mm,第三天加用毒扁豆碱,第一次静注0.5mg,注后35分钟能唤醒,言语欠清,1小时后复注0.5mg,后改为1mg qh 静注,在48小时内总量达18mg,意识清楚,心率88,双侧肢体肌力5°,膝反射出现,复查肝、肾功能及心电图均正常.
Zhang Moumou, female, 56 years old, swallowed amitriptyline 2100mg and nitrozepam 420mg 3.5 hours ago. Examination: T 3 ℃ (axillary), P112, R 24, BP 126/80, deep coma, both sides of the pupil and other large diameter 3mm, photic reaction slow, cardiorespiratory (-), relaxation of muscle tone, bilateral limb muscle strength 0 °, knee reflex did not knock out, pathological reflex (-), liver and kidney function was normal, EKG showed sinus tachycardia .Human hospital energy, the United States Xie Mian and other treatment, the condition did not improve, body temperature rose to 39.2 ℃ (Axillary), face flushing, dry skin. Pupil diameter 4 mm, plus physostigmine on the third day, the first intravenous injection of 0.5mg, 35 minutes after the injection can wake up, speech is not clear, 1 hour after reperfusion 0.5mg, later changed to 1mg qh intravenous injection, at 48 hours, the total amount of 18mg, awareness, heart rate 88, bilateral limb muscle strength 5 °, knee reflex appears, check the liver, kidney function and ECG were normal.