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患者男,46岁,右唇疖肿压挤后右侧眼睑皮肤肿胀、潮红半月余,以右眼眶蜂窝组织炎收入院。检查:T39℃、P80次/min,视力:右眼0.15,左眼0.6.右眼眶组织触摸星坚硬感,眼球完全固定,瞳孔4mm,对光反应消失,视神经乳头高度水肿约+5.0D,视网膜血管扩张纡曲.实验室检查:白细胞32×10~9/L,N0.90,L0.10。肾功能NPN7.14mmol/L.CO_2CP26.5mmol/L.血培养未见细菌生长.入院后给予大量抗生素(先锋霉素5号8.0g。新型青霉素Ⅱ号8.0g)、地塞米松20mg、脱水剂、支持疗法、输血,第3d 下午病情恶化,深昏迷,颈强直,同时左侧眼球突出,瞳孔5mm,视神经乳头水肿,血压下降至11/7kPa,反复输血、脱水、扩张血管药物治疗,病情稳定,第7d 眼睑皮肤肿
Male, 46 years old, right lip carbuncle swollen right eyelid swollen skin, flushing more than half a month, to the right orbital cellulitis income hospital. Examination: T39 ℃, P80 times / min, visual acuity: right eye 0.15, left eye 0.6 right eye orbital tissue touch star hard, the eye completely fixed, pupil 4mm, the light reaction disappeared, optic disc height edema about +5.0 D, Vasodilation 纡 song. Laboratory tests: Leukocytes 32 × 10 ~ 9 / L, N0.90, L0.10. Renal function NPN7.14mmol / L.CO_2CP26.5mmol / L. No bacterial growth in blood culture after admission to give a large number of antibiotics (cephalosporin No. 5 8.0g. New penicillin No. 2 8.0g), dexamethasone 20mg, dehydrating agent , Supportive therapy, blood transfusion, the first three days of the disease deteriorated, deep coma, neck stiffness, while the left eyeball prominent pupil 5mm, papilledema, blood pressure dropped to 11 / 7kPa, repeated blood transfusion, dehydration, dilation of blood drug treatment, stable condition , 7d eyelid skin swelling