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患者,女,38岁,2010年7月25日因上呼吸道感染来我院门诊就诊,门诊给予头孢呋辛5.0 g(南昌立建药业有限公司,规格:2.5 g,批号:201005037)+0.9%氯化钠注射液250ml,ivd qd,滴速约50滴/min,未用其他药物。第3天患者在静滴上述药液还剩约80 ml时出现左侧腰部剧烈疼痛,立即停止输液。患者诉肉眼可见鲜红色血样尿,尿液中有结晶,无尿频、尿急、尿痛,无恶心、呕吐,无发热、寒战,无皮疹、腹泻,自觉颜面水肿。急查尿常规示潜血(+++),蛋白(++),白细胞(+-),红细胞235个/μl,上皮细胞42个/μl;B超提示左肾积水并输尿管上段扩张,右肾缺如。门诊以“左肾积水原因待查:急性肾衰?”收冶入院,入院后体检:T37.0℃,P 80次/min,R 20次/min,BP 110/70 mmHg,急性病容,颜面轻度水肿,心肺听诊无异常,腹平软,左肾区叩痛。肾功能示尿素2.8 mmol·L,肌酐83μmol·L,尿酸245μmol·L~(-1)。诊断为左肾积水。给予解痉、补液、利尿、止血等支持对症处理,嘱患者多饮水,保持排尿通畅。治疗3 d
Patients, female, 38 years old, July 25, 2010 due to upper respiratory tract infection to our hospital clinic, outpatient cefuroxime 5.0 g (Nanchang Li Jian Pharmaceutical Co., Ltd., specifications: 2.5 g, lot number: 201005037) +0.9 % Sodium chloride injection 250ml, ivd qd, drip rate of about 50 drops / min, no other drugs. On the third day, the patient left severe pain in the left waist when intravenous infusion of about 80 ml of the above liquid was left intravenously. Stop the infusion immediately. Patient complained of visible bright red blood sample urine, urine crystallization, no urinary frequency, urgency, dysuria, no nausea, vomiting, no fever, chills, no rash, diarrhea, conscious facial edema. Urine routine examination revealed occult blood (+++), protein (++), white blood cells (+ -), erythrocytes 235 / μl, epithelial cells 42 / μl; B ultrasound prompt left renal hydronephrosis and ureteral dilatation Kidney missing. Outpatient to “left hydronephrosis to be investigated: acute renal failure?” Receiving admission, admission after examination: T37.0 ℃, P 80 times / min, R 20 times / min, BP 110/70 mmHg, acute disease Volume, facial mild edema, cardiopulmonary auscultation no abnormalities, abdominal soft, peritoneal pain in the left kidney area. Renal function showed urea 2.8 mmol·L, creatinine 83 μmol·L, uric acid 245 μmol·L -1. Diagnosis of left hydronephrosis. Give antispasmodic, rehydration, diuretic, bleeding and other support symptomatic treatment, Zhu Huanzhe more water, keep urination unobstructed. Treatment for 3 days