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患孩男,6岁。于入院前7天因被小犬咬伤左手,家属自行给予中草药一包,内含斑蟊虫3克,水煎内服。服后一小时出现恶心呕吐,初为胃内容物及清水,继之为鲜红及紫黑色血液,量较多,共呕吐7次。腹痛剧烈,尿量极少,色赤。出汗,高热,抽搐较频。体检:T39℃,神志不清,烦燥,颈软;瞳孔散大,面色灰白;呼吸深大,时有暂停。口唇、颊粘膜及舌体可见水泡和溃烂;齿龈、扁桃体红肿、糜烂;两肺呼吸音粗糙,闻及痰鸣音。心率140次/min,律不齐,心音低钝,无杂音。腹胀明显,肠鸣存在,肝脾(一)。血象:白细胞24×10~9/L,中性81％,淋巴19％;CO_2CP8.09mmol/L。入院次日解肉眼血尿,大便为鲜红及黑色。入院后经给O_2,输液,呼吸兴奋剂,抗炎,激素、纠酸,纠正水电失衡,止血,降颅压及对症支持疗法,保持呼吸道畅通,鲜蛋清胃内注入,同时给予中药黄柏5g煎汁加蛋清注入胃内解毒等综合措施,患孩转危为安。住院9天,痊愈出院。
Child boy, 6 years old. 7 days before admission because of being bitten by a dog left hand, the family members give themselves a package of Chinese herbal medicine, containing 3 grams of spotted worm, decoction orally. One hour after serving nausea and vomiting, the beginning of the stomach contents and water, followed by red and purple black blood, more volume, a total of vomiting 7 times. Severe abdominal pain, very little urine, color red. Sweating, fever, convulsions more frequent. Physical examination: T39 ℃, confusion, irritability, neck soft; mydriasis, pale; breathing deep, sometimes suspended. Lips, buccal mucosa and tongue visible blisters and ulcers; gums, tonsil swelling, erosion; rough breathing sounds of both lungs, smell and phlegm sounds. Heart rate 140 beats / min, irregular, heart sound low blunt, no noise. Significant abdominal distension, bowel, liver and spleen (a). Blood: white blood cells 24 × 10 ~ 9 / L, neutral 81%, lymph 19%; CO_2CP8.09mmol / L. On the next day solution to gross hematuria, stool is bright red and black. Admission to O_2, infusion, respiratory stimulants, anti-inflammatory, hormones, correct acidosis, water and electricity imbalance, hemostasis, reducing intracranial pressure and symptomatic and supportive therapy, to maintain the airway clear, fresh egg clear stomach injection, Juice plus egg white into the stomach detoxification and other comprehensive measures, the child turns critically ill. Hospitalized for 9 days, discharged.