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患者,男,55岁,因呕血两次约1000ml,于1986年11月6日急诊入院。两年来常有反复发作的上腹痛,无明显节律性,伴返酸,暖气。体检:神清,贫血貌,上腹有轻压痛。诊断:消化性溃疡合并大出血。入院后立即给止血、输血等治疗,同时给甲氰眯胍0.4静滴,用后偶有神志恍惚。第2天又呕血一次约500ml,除止血和输血外,又给甲氰眯胍0.6静滴,用后患者逐渐出现嗜睡,有时谵妄,继之出现浅昏迷。检查无特殊阳性体征。后停用甲氰眯胍,一天后患者神志由昏迷转为朦胧,两天后完全清醒。出血停止一周后作钡餐检查为胃小弯溃疡,给雷尼替丁0.15,一日2次口服,无任何反应。
The patient, male, 55 years old, was admitted to the emergency department on November 6, 1986 due to about 1000 ml of hematemesis twice. Two years often recurrent upper abdominal pain, no obvious rhythm, with acid reflux, heating. Physical examination: Shen Qing, anemia appearance, mild tenderness on the abdomen. Diagnosis: peptic ulcer combined with bleeding. Immediately after admission to stop bleeding, blood transfusions and other treatment, while 0.3 cyanide squint guanidine, after using occasional trance. On the second day hematemesis once again about 500ml, in addition to hemostasis and blood transfusions, but also to intravenous hexamidine 0.6 intravenous infusion, after patients gradually lethargy, and sometimes delirium, followed by a shallow coma. Check no special positive signs. After stopping the use of cyanamide glycosidine, a day after the patient’s consciousness from a coma to dim, completely awake two days later. One week after the bleeding stop for barium meal examination for gastric ulcer, ranitidine 0.15, 2 times a day orally, without any response.