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患者男性,31岁,农民.因发热5天、少尿3天,于1989年11月16日入院.入院时体检:T36.4℃,BP17.3/12.0kPa,P72次/分.呈酒醉貌,球结合膜充血水肿明显,并可见散在性出血点,上腭出血点呈点状和簇状,齿龈有少量渗血,两侧肾区叩击痛(+).血Hb116g/L,WBC46.2×10~9/L,N94%,PL 25×19~9/L,异常淋巴细胞16%.BUN82.5mmol/L,Cr 825μmol/L.血钾1.47mmol/L,血钠134mmol/L,血氧98mmol/L.尿蛋白+++,红细胞++.血清出血热特异抗体测定1∶1250阳性.入院后24小时尿量少于300ml,诉右腰部持续性疼痛,进行性加重,不能翻身.嗣后,短时间内腹部出现移动性浊音,腹腔穿刺抽得血性液体,B型超声波探查提示右肾形态饱满,下极附近可见不规则液性暗区,暗区向下腹部延伸形成巨大液性包块,其范围约13.6×7.6 cm,腹腔内有不规则游离暗区.复查血Hb70g/L,心率140～160次/分,BP5.3/?kPa.即予快速扩充血容量,血压逐渐回升至正常水平,经外科会诊后进行紧急手术.术中见
Male, 31 years old, farmer. Fever for 5 days, oliguria for 3 days, was admitted on November 16, 1989. Physical examination on admission: T36.4 ℃, BP17.3 / 12.0kPa, P72 / Blubber, the ball combined with membrane congestion and edema was obvious, and visible scattered bleeding point, the palate bleeding points were point-like and cluster-like, a small amount of bleeding gums on both sides of the kidney area percussion pain (+) Blood Hb116g / L, WBC46.2 × 10-9 / L, N94%, PL25 × 19-9 / L, abnormal lymphocytes 16% .BUN82.5mmol / L, Cr825μmol / L. Potassium 1.47mmol / L, L, blood oxygen 98mmol / L. Urinary protein +++, red blood cells ++. Serum hemorrhagic fever antibody specific determination of 1:1250 positive .24 hours after admission, urine output less than 300ml, complained of persistent pain in the right lower back, progressive increase, Subsequently, a short period of time the abdomen appeared mobile dullness, abdominal puncture pumping bloody fluid, B-mode ultrasound probe showed full right kidney morphology, irregular liquid dark area can be seen near the bottom of the dark area to the lower abdomen extended to form a huge The size of the liquid mass is about 13.6 × 7.6 cm and there are irregular free dark areas in the abdominal cavity.Here blood Hb70g / L, heart rate 140 ~ 160 beats / min, BP5.3 /? KPa, Blood pressure gradually rose back to normal levels, after surgical consultation Emergency surgery. Surgery see