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病例摘要:女,20岁,防疫员,住院号16598。患者于1976年6月5日因嗅到“敌敌畏”药味,即感觉头晕、头痛、恶心、四肢抽搐,随即昏迷,诊断为有机磷中毒,即注用阿托品、解磷毒等药物无效,送我院急诊转入院治疗。入院时体查:神清,双侧瞳孔散大约4毫米,对光反射灵敏,颈软,心肺正常,腹平软,全腹无压痛,肝、脾未扪及,肠鸣音正常,四肢活动正常,无病理神经反射,胆碱脂酶活力测定结果90％。患者入院时,仍有不同程度的四肢抽搐,肌注苯巴比妥钠0.2克后,患者即安静,再过15分钟,患者一切正常,能起床活动。住院1周,用安定、谷氨酸、菸酸等药物治疗,于6月13日痊愈出院。出院时,自觉无任何不适,体查无阳性体征,诊断为有机磷中毒后遗症——癔病样发作。
Case Summary: Female, 20 years old, epidemic prevention staff, hospital number 16598. Patients on June 5, 1976 due to smell “dichlorvos” flavor, that feeling dizzy, headache, nausea, limbs convulsions, and then coma, diagnosed as organophosphate poisoning, that is, injection of atropine, detoxification and other drugs ineffective, send me Emergency hospital admission to hospital for treatment. Physical examination on admission: Shen Qing, bilateral pupil scattered about 4 mm, sensitive to light reflex, neck soft, normal heart and lung, abdominal soft, full no tenderness, liver, spleen not palpable, normal bowel sounds, limb activity Normal, pathological reflex, cholinesterase activity determination of 90%. Patients admitted to hospital, there are still varying degrees of limb twitching, 0.2 g of phenobarbital sodium intramuscular injection, the patient is quiet, and then 15 minutes, all patients normal, able to get up. Hospitalized for 1 week, with diazepam, glutamic acid, niacin and other drugs, was discharged on June 13. Discharged, consciously without any discomfort, physical examination without positive signs, diagnosis of organophosphate poisoning sequelae - hysteria-like illness.