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病史摘要: 男性、63岁。有长期嗜酒史和慢性胰腺炎,长期服用胰酶制剂,病人仃服胰酶可引起腹泻及消瘦。有排尿不适感,已有6天未进饮食,因体温升至38.5℃、白细胞19,000/毫米~3被拟诊为败血症而入院。体检:血压120/90毫米汞柱,脉率98次/分,呼吸28次/分,肛门体温38.5℃。皮肤弹性很差,舌干而有裂纹。颈略有抵抗,两侧肋脊角有压痛,能辨明人和地点,但不能辨别时间。神经系统无定位症状。实验室检查:红细胞压积34%,白细胞19,900/毫米~3,杆状12%,中性分叶76%,淋巴8%,大单核4%,血小板107,000/毫米~3,导尿标本:蛋白+++,白细胞多达无法计数,涂片可见固紫阴性杆菌。血尿素氮
History Summary: Male, 63 years old. Long history of alcohol abuse and chronic pancreatitis, long-term use of pancreatic enzyme preparations, patients with pancreatic enzymes can cause diarrhea and weight loss. There is urinary discomfort, have not been into the diet for 6 days, as body temperature rose to 38.5 ℃, 19,000 / mm3 leukocytes were diagnosed as sepsis and hospitalization. Physical examination: blood pressure 120/90 mm Hg, pulse rate 98 beats / min, breathing 28 beats / min, anus temperature 38.5 ℃. Skin elasticity is poor, dry tongue and cracked. The neck is slightly resistant, tender ribs on both sides of the ridge angle, to identify people and places, but can not tell the time. Nervous system no symptoms. Laboratory tests: hematocrit 34%, leukocyte 19,900 / mm3, rod 12%, neutral lobes 76%, lymphatic 8%, large mononuclear 4%, platelets 107,000 / mm3, catheterization specimens: Protein +++, as many as can not count white blood cells, smear shows solid purple-negative bacilli. Blood urea nitrogen