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患者男,32岁。因误服杀虫脒15ml,静注美蓝240 mg后,出现严重紫绀,呼吸节律不整于1984年9月12日晚入院。体检:体温不升,脉搏60次,呼吸14次,血压110/70。神志不清,压眶反射消失,球结膜明显水肿,双侧瞳孔散大,对光反射消失。唇、甲床重度紫绀,呼吸深慢呈双吸气。心率60次,律齐,心音低钝。血红蛋白15克,白细胞8300,N 78%,L20%、E 2%。尿:红细胞++,蛋白+。血钾13.7mg%、钠265 mg%、氯530 mg%。二氧化碳结合力22.4容积%。考虑为杀虫脒中毒,美蓝过量致呼吸衰竭。
Male patient, 32 years old. Due to misdiagnosis of chlordimeform 15ml, intravenous injection of methylene blue 240mg, severe cyanosis, respiratory rhythm is not the whole on the night of September 12, 1984 admission. Physical examination: body temperature does not rise, pulse 60 times, breathing 14 times, blood pressure 110/70. Confusion, pressure orbital reflex disappeared, bulbar conjunctiva obvious edema, bilateral mydriasis, light reflex disappeared. Lips, nail bed severe cyanosis, breathing was slowly breathing double. Heart rate 60 times, law Qi, low heart sound blunt. Hemoglobin 15 grams, white blood cells 8300, N 78%, L20%, E 2%. Urine: erythrocyte ++, protein +. 13.7 mg of potassium, 265 mg of sodium and 530 mg of chlorine. Carbon dioxide binding force 22.4 vol%. Considered as chlordimeform poisoning, methylene blue caused by respiratory failure.