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1、病例介绍 患者,女,38岁,因吞服120片降糖灵5小时,恶心、呕吐、烦躁、大汗4小时,于1994年3月7日10pm入院,既往有糖尿病史10余年,巴金森氏病史3年。体检:T35℃,P104次/分,R24次/分,BP9.6/5.3kpa,神志清,烦躁不安,面色苍白,四肢湿冷,瞳孔等大等圆,对光反射迟钝,口唇微绀,颈软,呼吸深快,心音低钝,律整。腹软,无压痛,四肢粗颤动,肌张力增高,病理征未引出。EKG:窦性心动过速。急查血糖测不到,疑试剂失效而未报告结果。血酮体(一)、CO_2CP6.8mmol/L,尿糖(一),尿酮体(一)。入院诊断:降糖灵中毒,低血糖反应,乳酸性酸中毒、休克。
1, the case description The patient, female, 38 years old, due to swallow 120 hypoglycemic 5 hours, nausea, vomiting, irritability, sweating 4 hours at 10pm on March 7, 1994 admitted to the hospital, past history of diabetes more than 10 years, His history of 3 years. Physical examination: T35 ℃, P104 beats / min, R24 beats / min, BP9.6 / 5.3kpa, clear mind, irritability, pale, limbs cold, pupil and other large round, slow light reflex, Soft, fast breathing, low heart sound blunt, law. Abdominal soft, no tenderness, limbs rough fibrillation, muscle tension increased, the pathological levy did not lead. EKG: Sinus tachycardia. Rapid detection of blood glucose can not be measured, suspected of failure but failed to report the results. Blood ketone body (a), CO_2CP6.8mmol / L, urine sugar (a), urinary ketone body (a). Admission diagnosis: hypoglycemic poisoning, hypoglycemia, lactic acidosis, shock.