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患者过××,男,40岁,住院号224481。患者在入院前10天开始发热,体温38.5～39℃,伴乏力、纳差、上腹闷痛,经对症治疗后第三天热退。第六天出现频繁呕吐、头晕、口渴、多饮、多尿。入院当天上午给予10%葡萄糖液1,500毫升静脉滴注及抗菌素等治疗。下午一时左右患者烦燥不安,继而神志不清,心律不齐,心率28次/分,心电图示室性自主节律,即给予阿托品0.5毫克,异丙基肾上腺素1毫克和11.2%乳酸钠40毫升静脉推注后收入院。过去史:否认有糖尿病和心脏病史。体格检查:血压82/50毫米汞柱,神志不清呈浅昏迷,极度烦燥,轻度脱水,瞳孔等大,对光反应迟钝。
Patients over × ×, male, 40 years old, hospital number 224481. Patients 10 days before admission fever, body temperature 38.5 ~ 39 ℃, with fatigue, anorexia, abdominal pain, symptomatic treatment by the third day after the heat back. The sixth day of frequent vomiting, dizziness, thirst, polydipsia, polyuria. The morning of admission to give 10% glucose solution 1,500 ml intravenous infusion and antibiotics and other treatment. At about 1:00 pm, the patient was irritable, and then unconscious, arrhythmia, heart rate 28 beats / min, ECG showed ventricular autonomic rhythms, that is given atropine 0.5 mg, isoproterenol 1 mg and 11.2% sodium lactate 40 ml intravenous push Note after income hospital. Past history: Denied history of diabetes and heart disease. Physical examination: blood pressure 82/50 mm Hg, unconscious was shallow coma, extremely irritable, mild dehydration, pupils and other large, slow reaction to light.