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患者女,43岁。5年前患过精神分裂症。因与他人发生纠纷,于1989年4月9日8时左右,自己顿服阿米替林96片(每片25mg)。12时被他人发现共沉睡不醒,唤之不应,于13时送入我院。门诊给于补液、利尿、肌注洛贝林,观察4个半小时无效,即收入病房。检查体温36.5℃,脉搏98,呼吸16,血压17.33/12.00kPa(130/90mmHg)。深昏迷,压眶无反应,角膜反射消失,两眼瞳孔等大(3mm),对光反射消失。两肺闻及痰鸣音。心率98,律齐,心音低钝。肝、脾不肿大,肠鸣音较弱。实验室检查:白细胞12.1×10~9/L,中性0.85;血钾、钠、氯、钙、二氧化碳结合力、尿素氮均正常。心电图为窦性心动过速。诊断:阿米替林中毒性昏迷。
Female patient, 43 years old. Had schizophrenia 5 years ago. As a result of disputes with others, on April 9, 1989, at about 8 o’clock, we served a sudden amitriptyline 96 (25mg per tablet). At 12 o’clock, he was found to have been asleep and awake. He was called into the hospital at 13:00. Out-patient for rehydration, diuretic, intramuscular Lobelin, observed 4 and a half hours is invalid, that income Ward. Check body temperature 36.5 ℃, pulse 98, breath 16, blood pressure 17.33 / 12.00kPa (130 / 90mmHg). Deep coma, no pressure orbital reflex, disappearance of corneal reflex, two pupils and other large (3mm), the light reflection disappears. Both lungs and phlegm heard. Heart rate 98, law Qi, low heart sound blunt. Liver, spleen does not enlarge, bowel sounds weaker. Laboratory tests: leukocytes 12.1 × 10 ~ 9 / L, neutral 0.85; potassium, sodium, chlorine, calcium, carbon dioxide binding, urea nitrogen are normal. ECG for sinus tachycardia. Diagnosis: Amitriptyline toxic coma.