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患者,男,52岁,农民.因发热,双下肢关节疼痛1周入院.查体:体温37.6℃,脉搏82次/分,血压15.9/10.6kPa(119/79mmHg),咽部无充血,心肺腹无异常,双下肢踝关节灼热.化验:白细胞11×10~9/L,中性0.80,淋巴0.20,血沉35mm/h,拟诊:急性风湿性关节炎.经青霉素皮试阴性,静滴青霉素480万U,无不良反应.续滴能量合剂(肌苷0.2g,三磷酸腺苷40mg,维生素B_6100mg,辅酶A100U加入500ml10%葡萄糖注射液中,约10分钟后,患者感心悸,胸闷,给减慢输液速度,又5分钟后,患者出现喘促,烦躁不安,大汗淋漓,伴有便意,继之神志不清,出现小便失禁.急查:口唇发绀,四肢湿冷,脉搏细弱,血压3.9/OkPa(29/0mmHg),双肺阴性,心率120次/分,律齐,心音低.立即终止输液,平卧
Patient, male, 52 years old, farmer .Heart fever, lower extremity joint pain 1 week admission. Physical examination: body temperature 37.6 ℃, pulse 82 beats / min, blood pressure 15.9 / 10.6kPa (119 / 79mmHg), pharynx without congestion, Abdominal abnormalities, both lower extremity ankle seizures. Test: leukocytes 11 × 10 ~ 9 / L, neutral 0.80, lymph 0.20, erythrocyte sedimentation rate 35mm / h, proposed diagnosis: acute rheumatoid arthritis. Penicillin skin test negative, Penicillin 4.8 million U, no adverse reactions. Continued drop of energy mixture (inosine 0.2g, adenosine triphosphate 40mg, vitamin B_6100mg, coenzyme A100U added 500ml10% glucose injection, about 10 minutes later, patients with palpitation, chest tightness, to slow infusion Speed, and 5 minutes later, the patient wheezing, irritability, sweating, accompanied by the meaning, followed by unconsciousness, urinary incontinence. 急查: lips cyanosis, cold limbs, weak pulse, blood pressure 3.9 / OkPa ( 29 / 0mmHg), lungs negative, heart rate 120 beats / min, law Qi, low heart sound immediately stop infusion, supine