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1、急性有机磷农药中毒的护理查房Acuteorganophosphatepesticidepoisoning（AOPP）carerounds2011/8/18病例介绍伍南臻患者，周桂云，女性，46岁入院时间：2011-08-07主诉：呕吐、口吐白沫、神志不清、大小便失禁4小时Patients,guiyunZhou,female,46yearsoldAdmissiontime：2011-08-07ChiefComplaint:vomiting,foamingatthemouth,confusion,incontinence4hours基本资料1病例介绍现病史：患者于4小
2、时前因争吵后自服农药（半硫磷）约100ML，服用后出现神志改变。Historyofpresentillness,Forfourhoursafteranargumentwithhisfamilybefore,Shetakethepesticideabout100Milliliters,Pesticidesconsideredforthehalfsulphurphosphoric.Aftertakeappearmindchange.病例介绍家人行紧急救治后送入当地医院行洗胃治疗，于2011-08-0712:20急诊平车转入我院肾病内科Patientsaftermedi
3、cationwithvomiting,aftertheemergencysalvage,shewassendtothelocalhospitalforgastriclavageforherfamliy.Inaugust7,201112:20,Shewastransferredtoourhospitalnephropathyinternalmedicinewithemergencyflatcar.病例介绍转运途中出现呕吐，大小便失禁症状。门诊以“急性有机磷农药中毒”收治。起病以来，精神差，体重无明显变化。Intransit,Patientshadrepeatedvo
4、mitingandEliminationofurineandfecesarenotcontrolledbyherself,ClinicdiagnosisisAOPP,Afterthepatientisadmittedtohospital,herSpiritwassobadandweightdidnothavesignificantlychange.病例介绍既往有肺脓肿病史，已行部分肺叶切除术，术中有输血，有青霉素过敏史。shehadlungabscessbefore,andwasdoneapartiallobectomy,inthatoperation,Sheha
5、dabloodtransfusion.ThemostimportantisshehadthePenicillinallergy.病例介绍全凤春体格检查：T35.8℃P126次/分R20次/分BP109/69mmHgPhysicalexamination:Temperature：35.8℃,Pulse:126BeatPerMinute,respiration:20BeatPerMinute,BloodPress109/69mmHg病例介绍神志浅昏迷，双侧瞳孔等大等圆3mm,对光反射迟钝，口唇发绀，皮肤湿冷，双肺呼吸音粗，可闻及大量湿性啰音。Comaconscious
6、ness,Pupilsareequalroundnessandsamesizewith3mm,reactiontolightshowsdelay,whilethelipsiscyanotic,BreathsoundshowsCoarsewhileitCanbeheardandalotofwetrales.病例介绍心率126次/分，肠鸣音活跃，四肢肌张力稍高，无自主活动，病理反射未引出。Heartrateis126BeatPerMinute,borhorygmusshowsincreased,Limbmuscletoneisslightlyhigher,therei
7、snoindependentactivity,Pathologicalreflexisnotelicited.病例介绍刘伟明入院诊断:1、急性重症农药中毒（半硫磷）2、中毒性心肌炎3、吸入性肺炎Admissiondiagnosis:1、severeacutepesticidepoisoning(halfsulphurphosphorous)2、toxicmyocarditis3、aspirationpneumonia主要病情变化马志群8-801:40T39.1摄氏度，予温水擦浴05：20患者开始出现躁动，予丙泊酚5毫升IV效果不明显，予地西泮镇静Onefortyo
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