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患者,女,68岁,农民,1990年12月8日入院。入院前因高热,全身性猩红热样皮疹,住当地医院,拟诊为流行性出血热、败血症,给予抗生素等治疗10天后因高热不退、低血压、休克转我院。检查:体温39.5℃,脉搏120次/min,呼吸24次/min,血压11/8kPa,神志淡漠,面部潮红,眼结膜充血,全身皮肤呈猩红热样皮疹,面及四肢浮肿,鼻唇周围皮肤疱疹出血,杨梅舌,口腔粘膜充血水肿,呕吐,腹胀,腹泻,尿少。白细胞23.5×10~9/L,N 0.92,L 0.10,血小板70×10~9/L,血红蛋白80g/L,尿蛋白(++),脓细胞少数,上皮细胞少数,大便隐血阴性,Cr219μmol/L,BUN28.6mmol/L,血钾5.2mmol/L,钠126mmol/L,氯90mmol/L,钙3.5mmol/L。肝功能:SGPT 200U,T 55g/L,A 33g/L,G 22g/L。心电图:示窦性心动过速,低电压。肥达氏反应阴性。入院诊断:中毒性休克,结予扩容、纠酸、强心、升压、激素、
Patient, female, 68 years old, farmer, admitted to hospital on December 8, 1990. Before admission due to high fever, systemic scarlet fever-like rash, live in a local hospital, to be diagnosed as epidemic hemorrhagic fever, septicemia, given antibiotics and other treatment for 10 days due to high fever, hypotension, shock transferred to our hospital. Check: body temperature 39.5 ℃, pulse 120 beats / min, breathing 24 beats / min, blood pressure 11 / 8kPa, apathetic, facial flushing, conjunctival hyperemia, systemic skin scarlet fever-like rash, facial and limb edema, Bleeding, bayberry tongue, oral mucosal congestion and edema, vomiting, bloating, diarrhea, oliguria. Leukocytes 23.5 × 10-9 / L, N 0.92, L 0.10, platelets 70 × 10-9 / L, hemoglobin 80g / L, urinary protein (++), a small number of pus, a small number of epithelial cells, fecal occult blood negative, Cr219μmol / L, BUN 28.6mmol / L, serum potassium 5.2mmol / L, sodium 126mmol / L, chlorine 90mmol / L, calcium 3.5mmol / L. Liver function: SGPT 200U, T 55g / L, A 33g / L, G 22g / L. ECG: show sinus tachycardia, low voltage. Widal reaction negative. Admission diagnosis: toxic shock, give expansion, correcting acid, cardiac, boost, hormones,