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男患:54岁,既往无肾病及胃病史。四天前因腹痛、脓血便3天伴神智不清,无尿1天于1990年9月10日由阿左旗医院转入我院。在阿左旗医院血压一度为0,经氨苄青霉素及扩容升压药治疗后血压正常。查体:体温35℃,脉搏100次/min,血压19.95/11.97kPa,呼吸24次/min,神智模糊,心肺未见异常,腹平软、无压痛及反跳痛。实验室检查:血红蛋白128g/L,白细胞17.7×10~9/L,中性0.80,血尿素氮86.31mmol/L,血肌酐844.8mmol/L二氧化碳结合力27.2mmol/L,血钾5.8mmol/L。便常规:脓血便。镜检:红细胞、脓细胞满视野。便培养:福氏痢疾杆菌。血培养(一)。治疗过程:静推10％葡萄糖酸钙10ml,4小时后再给一次以治疗高血钾。给氨苄青霉素静滴
Male suffering: 54 years old, no past history of kidney disease and stomach. Four days ago due to abdominal pain, pus and blood 3 days accompanied by confusion, anuria 1 day in September 10, 1990 from A left Banner Hospital into our hospital. A left-flag hospital blood pressure was 0, after ampicillin and vasopressors treatment of blood pressure normal. Examination: body temperature 35 ℃, pulse 100 beats / min, blood pressure 19.95 / 11.97kPa, breathing 24 beats / min, divination fuzzy, no abnormal heart and lungs, abdominal soft, no tenderness and rebound tenderness. Laboratory tests: hemoglobin 128g / L, leukocytes 17.7 × 10 ~ 9 / L, neutral 0.80, blood urea nitrogen 86.31mmol / L, serum creatinine 844.8mmol / L carbon dioxide binding 27.2mmol / L, serum potassium 5.8mmol / L . Then routine: pus and blood. Microscopy: erythrocytes, pus full vision. Will be cultured: Shigella flexneri bacteria. Blood culture (a). Treatment process: Static push 10% calcium gluconate 10ml, 4 hours after giving once again to treat hyperkalemia. Ampicillin intravenous infusion