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患者,男,31岁,以头部外伤伴昏迷,躁动不安4h之代诉入院。查体:T37.0C,P71次/min,R20次min,BP日kPa,意识昏迷,GCS计分6分,双瞳孔等大等圆约0.3cm,光反应迟饨,脑膜刺激征(+),心肺腹(-),左下肢肌力0～1级,肌张力减低,膝反射消失,右下肢膝反射正常,巴氏征(-)。CT示:广泛性脑挫裂伤,中线右移1.0cm。入院后给维生素B_1、青霉素、甘露醇、地塞米松等止血、抗炎、降颅压处理。入院时查肝功,总胆红素12.2μmol/L,直接胆红素28.0μmol/L,总蛋白47.4g/L,白蛋白39.4g/L,谷丙转氨酶正常,甲、乙、丙肝系列阴性,入院第2天加用速尿(蚌埠涂由制药厂,批号950227)20mg,肌注,2次/d,用药4d后出现巩膜黄染,逐渐加重,皮肤呈暗黄色,肝肋下1cm,质软缘锐,脾不
Patients, male, 31 years old, with head trauma with coma, restless 4h on behalf of the admission. Physical examination: T37.0C, P71 times / min, R20 times min, BP days kPa, unconsciousness, GCS score 6 points, double pupil and other large round about 0.3cm, , Cardiopulmonary abdominal (-), left lower extremity muscle strength 0 ~ 1, muscle tension decreased, knee reflex disappeared, right knee lower extremity reflex, Pakistan sign (-). CT showed: extensive cerebral contusion, midline shifted right 1.0cm. After admission to vitamin B_1, penicillin, mannitol, dexamethasone and other bleeding, anti-inflammatory, reducing intracranial pressure treatment. Admission liver function, total bilirubin 12.2μmol / L, direct bilirubin 28.0μmol / L, total protein 47.4g / L, albumin 39.4g / L, alanine aminotransferase normal, A, B and C negative , The second day of admission with furosemide (Bengbu Tu pharmaceutical factory, batch number 950227) 20mg, intramuscular injection, 2 times / d, 4d after scleral yellow dye, and gradually increased, the skin was dark yellow, liver ribs 1cm, Soft edge, spleen is not