极少数乳糜尿可以引起休克,称为重度乳糜尿或乳糜休克。我们曾收治1例,在诊断和治疗上都值得吸取教训。现报告如下。 男,65岁、间歇性乳糜尿20年,胸痛,乏力,纳差,乳糜尿加重1个月,于1981年5月11日入院。1963年开始间歇豆浆色尿,经治疗尿可转清,但易复发。1976年后乳糜尿逐渐加重。有2次阴囊肿大,经治疗后消退。1981年4月上旬感头昏、胸闷、纳差、尿频,尿如牛奶样,有凝块,以致排尿困难。4月10日在外院住院,血内找到微丝蚴,曾服海群生,全身症状及乳糜尿无改善。 检查:体温不升,脉搏92次,细弱,血压80mmHg。极度消瘦,重病容。双颔下各可触及黄豆大淋巴结一个,活动,轻触痛。双肺未闻及啰音,心音弱,律齐。肝在右肋下4cm可触及。附睾及精索未触及结节。尿乳糜试验阴性尿培养无苗生长。血清总蛋白3.85g,A/G=1.(?)5/1。BUN44mg％。入院后行膀胱镜检膀胱内充满乳糜血块,无法观察。因乳糜块阻塞,排尿极端困难,于5月20日行耻骨上膀胱切开取出大量乳糜血块,观察5分 A very small number of chyluria can cause shock, known as severe chyluria or chyma shock. We have admitted to a case, both in the diagnosis and treatment are worth learning from. The report is as follows. Male, 65 years old, intermittent chyluria for 20 years, chest pain, fatigue, anorexia, chyluria increased 1 month, on May 11, 1981 admission. Intermittent soy milk color urine in 1963, the urine can be treated to clear, but easy to relapse. After 1976, chyluria gradually increased. There are 2 times scrotal swelling, subsided after treatment. Early April 1981 feeling dizzy, chest tightness, anorexia, frequent urination, urine, such as milk-like, clot, resulting in dysuria. April 10 hospitalized outside the hospital to find microfilaria in the blood, had served seaquakes, systemic symptoms and no improvement in chyluria. Check: body temperature does not rise, the pulse of 92 times, weak, blood pressure 80mmHg. Extremely thin, seriously ill. Double 颔 each can reach a large lymph nodes, activities, touch the pain. Unaware of lungs and rales, weak heart, law Qi. Liver in the right rib 4cm reach. Epididymis and spermatic cord did not touch the nodules. Urine chylous test negative urine culture seedling growth. Serum total protein 3.85g, A / G = 1 (?) 5/1. BUN44mg%. After admission line cystoscopy bladder filled with chylous blood clots, can not be observed. Blocked because of chylomicrons, urinating extremely difficult on May 20 line suprapubic bladder incision to remove a large number of chylous clots, observed 5 points