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男,31岁,化学工人。因氯仿泄漏大量吸入致中毒性昏迷、休克伴皮肤氯仿溶液大面积冻伤约50分钟急诊入院。 体查:昏迷状。面色紫绀,呼吸微弱。体温不升。脉搏扪不到。血压零。四肢皮肤冰冷间断抽搐。眼结膜充血。两侧瞳孔对称性散大,对光反射迟钝。牙关紧闭。颈部有抵抗感。两肺底部有小水泡音。心音低钝,心率104次。肝脾未扪及。浅反射消失,未引出病理反射。头面部、胸腹壁、臀部、四肢皮肤冻成紫红色。Ⅱ°—Ⅲ°。总面45％。血常规:血红蛋白156g/L,红细胞5.6×10~(12)/L,白细胞61.8×
Male, 31 years old, chemical worker. Due to a large number of chloroform leakage toxic poisoning coma, shock with large areas of chloroform solution of large frostbite about 50 minutes emergency admission. Physical examination: coma. Looks cyanotic, breathing weak. Body temperature does not rise. Pulse palpable. Zero blood pressure. Cold limbs and skin twitch. Conjunctival hyperemia. Pupil symmetry on both sides of scattered, slow reflection of light. Tight shut. Neck has a sense of resistance. Small blisters sound at the bottom of both lungs. Low heart sound, heart rate 104 times. Liver and spleen not palpable. Shallow reflex disappeared, did not lead to pathological reflex. Head and face, chest and abdomen, buttocks, limbs, skin into a frozen purple. Ⅱ ° -Ⅲ °. Overall 45%. Blood: Hemoglobin 156g / L, red blood cells 5.6 × 10 ~ (12) / L, white blood cells 61.8 ×