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病例;男性,62岁。1991年3月7日因肾功能异常半年,双下肢浮肿半月余入院,查体:T36.8,P84,R20,BP16/9,3kPa,慢性病容,贫血貌,神志清醒,皮肤巩膜无黄染,颜面轻度浮肿,口唇紫绀,双侧瞳孔等圆等大,双肺叩诊呈过清音,呼吸音稍粗,左下肺可闻及干性啰音,心率84次/分,律齐,心音低钝,各瓣膜区未闻及病理性杂音,腹平软,肝脾肋缘下未触及,无移动性浊音。双下肢中度凹性水肿,心电图检查为窦性心律、心肌劳损。X光胸片:尿毒症性心肌病及尿毒性肺改变(肺水肿,胸腔少量积液),左肺感染。BUN15.35mmol/L,Cr247.5μmol/L。入院诊断为慢性肾炎、慢性肾功能衰竭。给予泰利必妥,尿毒清、速尿、氨茶硷、苛甫定等治疗。3月9日上午10时给予低分子右旋糖酐500毫升静脉点滴(拟在静
Case; male, 62 years old. March 7, 1991 renal dysfunction for six months, double lower extremity edema more than half of the hospital admission examination: T36.8, P84, R20, BP16 / 9, 3kPa, chronic disease, anemia appearance, conscious, scleral no yellow dye , Mild facial edema, cyanosis of the lips, bilateral pupil and other large circle, bilateral percussion was voiceless, a little rough breathing sounds, left lung can be heard and dry rales, heart rate 84 beats / min, law Qi, low heart sound Obtuse, the valve area is not known and pathological murmur, abdominal soft, liver and spleen rib edge untouched, no mobility dullness. Moderate concave lower extremity edema, electrocardiogram as sinus rhythm, myocardial strain. X-ray: uremic cardiomyopathy and uremic lung changes (pulmonary edema, pleural effusion), left lung infection. BUN15.35mmol / L, Cr247.5μmol / L. Admission diagnosis of chronic nephritis, chronic renal failure. Given telbivudine, uremic Qing, furosemide, ammonia theophylline, Hyperactivity treatment. At 9:00 on the March 9 to give low molecular weight dextran 500 ml intravenous drip (to be quiet