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作者应用膦甲酸三钠(Foscarnet)成功地治疗了1例晚期肝昏迷患者。该病例为18岁的静脉内药物滥用者,7天来表现为不适、呕吐和进行性黄疸。入院时病人处于1级肝昏迷且黄疸加深,48小时后进展至5级肝昏迷伴伸肌痉挛和癫痫样发作。HBsAg(2个月前为阴性)和抗-δ阳性。凝血酶原比率3.2,胆红质245μmol/L,丙氨酸转氨酶3790 U/L,尿素11.8mmol/L,肌酐351μmol/L,葡萄糖5.5mmol/L。血培养有沙雷氏菌生长,对头孢氨噻肟敏感。随后,尿素升至19.2mmol/L,肌肝增至467mmol/L,但两者以后均转为正常。
The authors successfully treated one patient with advanced hepatic coma with Foscarnet. The case was an 18-year-old intravenous drug abusers who showed discomfort, vomiting and progressive jaundice in seven days. At admission, the patient was in grade 1 hepatic coma and deepened jaundice, and progressed to Grade 5 hepatic coma with extensor spasms and epileptic seizures 48 hours later. HBsAg (negative two months ago) and anti-delta-positive. Prothrombin ratio 3.2, 245 ugol / L bilirubin, alanine aminotransferase 3790 U / L, urea 11.8mmol / L, creatinine 351μmol / L, glucose 5.5mmol / L. Blood culture has Serratia bacteria growth, sensitive to cefotaxime. Subsequently, the urea rose to 19.2mmol / L, liver muscle increased to 467mmol / L, but both later became normal.