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有机磷农药中毒伴发血糖、尿糖显著增高和昏迷而被误诊为糖尿病昏迷者,文献中尚未见报告。现报告一例并略加讨论。 患者男,16岁,工人。因头痛、神志恍惚6天,昏迷、尿便失禁一天,于1981年2月20日入院。2月14日起,患者出现头痛、烦躁、失眠,流涎、多汗。当地医生按感冒治疗。头痛逐渐加重,纳减,全身乏力,走路不稳。全身大汗淋漓,嗜睡,神志恍惚。18日。到某公社医院就诊,发现患者颈项强直,克匿格征及布辛征均为阳性,诊断为“流行性脑脊髓膜炎”,给予青、氯霉素,皮质激素,输液等治疗,仍未好转。19日下午起,出现昏迷,尿便失禁。遂转来门诊,拟诊为散发性脑炎入院。
Organophosphorus pesticide poisoning associated with blood sugar, urine glucose was significantly higher and coma were misdiagnosed as diabetic coma, the literature has not been reported. Now report a case and a little discussion. Patient male, 16 years old, worker. Due to a headache, trance 6 days, coma, incontinence one day, in February 20, 1981 admission. February 14, patients with headache, irritability, insomnia, salivation, sweating. Local doctors treat cold. Headache gradually aggravating, satisfied, malaise, walking instability. Whole body sweating, drowsiness, trance. 18 days. To a commune hospital, and found that patients with neck stiffness, Keweige syndrome and Bussing levy are positive, diagnosed as “epidemic cerebrospinal meningitis”, given green, chloramphenicol, corticosteroids, infusion and other treatment, has not improved. On the afternoon of the 19th, a coma and urine were incontinent. Then turn to the clinic, to be diagnosed as sporadic encephalitis admitted to hospital.