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患者女,40岁。饮红葡萄酒200ml,4小时后出现面红、呕吐,伴轻微烦躁;次日凌晨4点,家属呼之不应,伴尿失禁,当地医生按醉酒给予含糖盐水1500ml加维生素类药物静滴治疗1天,未见好转,第三天上午急转我院。患者有糖尿病5～6年,一直口服D860,症状基本控制。查体:T36℃,脉搏扪不清,R30次/min,BP0。患者消瘦,呈深昏迷状,压眶上神经无反应。皮肤干燥,弹性差,双眼窝凹陷,两颊略潮红,口唇呈樱桃红色。呼吸深快,呼气有烂苹果味,双肺呼吸音略粗,四肢发凉,生理反射消失。化验:血糖32.54mmol/L;尿糖++++;尿酮体++++;血pH6.8; CO_2-
Female patient, 40 years old. Drink red wine 200ml, 4 hours after the redness, vomiting, with slight irritability; 4 o’clock the next day, relatives should not call, with incontinence, the local doctor according to drunk given sugar 1500ml of intravenous infusion of vitamins 1 day, no improvement, the third day morning sharp turn our hospital. Patients with diabetes 5-6 years, has been oral D860, the basic symptoms control. Physical examination: T36 ℃, pulse palpable, R30 times / min, BP0. Patients weight loss, showed a deep coma, pressure supraorbital nerve no response. Dry skin, poor elasticity, sunken eyes, cheeks slightly flush, cherry red lips. Breathing fast, exhaled rotten apple flavor, breath sound slightly coarse lungs, limbs, cold, physiological reflex disappeared. Assay: Blood sugar 32.54mmol / L; Urine sugar ++++; Urine ketone body ++++; Blood pH6.8; CO_2-