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患者,男,18岁,因双眼左上凝视4小时入院。入院前1天因腹泻,脓血便口服痢特灵0.1每日3次,共服5片;庆大霉素8万~U肌注,2次/日,共肌注2次。查体:双眼球向左上凝视并固定,向内下、外下及右侧方向运动受限,瞳孔大小正常,光反射正常,眼底不能窥视。 治疗:入院后即给以补液并肌注阿托品以解痉。6小时后患者自感双眼活动较前明显好转,次日晨即活动自如,视力恢复如病前。为了明确其原因,于次日又给庆大霉素16万~U静滴,未再出现上述症状。即往无痢特灵服药史。故双眼上直肌痉挛确系痢特灵的毒副作用所致。 讨论:痢特灵的副作用文献已有不少报道。主要有过敏反应和毒性作用。过敏反应最常见有荨麻疹样药疹,血管神经性水肿等;毒性作用以胃肠道症状为明显。但引起双眼上直肌痉挛实不多见。考虑是否因口服痢特灵引起的第Ⅵ对脑神经即展神经炎,使双眼上直肌一时痉挛所致。
Patient, male, 18 years old, hospitalized for 4 hours due to binocular left upper stare. 1 day prior to admission due to diarrhea, abstinence, blood and urine will be taken 0.1 times daily Furazolidone 5, a total of 5; gentamicin 80000 ~ U intramuscular injection, 2 times / day, a total of 2 intramuscular injection. Physical examination: both eyes to the left gaze and fixed to the inside, outside and right side of the restricted movement, pupil size normal, normal light reflex, the fundus can not peep. Treatment: given to hospital after infusion and intramuscular injection of atropine to antispasmodic. 6 hours after the patient’s self-reaction binocular activity was significantly improved compared with the previous day, morning activities that freedom, visual acuity before illness. In order to clarify its causes, in the next day gave gentamicin 160,000 ~ U intravenous infusion, no longer the above symptoms. That is, no history of taking furazolidone medication. Therefore, both eyes of the rectus muscle spasm really Department of toxic side effects caused by furazolidone. Discussion: There are many reports on the side effects of furazolidone. Mainly allergic reactions and toxic effects. The most common allergic reactions are urticaria-like drug eruptions, neurogenic edema, etc .; toxic effects of gastrointestinal symptoms as obvious. But caused by rectus muscle spasms on the eyes really rare. Consider whether the first Ⅵ caused by oral furazolidone neuritis that neuritis, so that both eyes caused by spasm spasm.