1　病历摘要患者男 ,36岁。因乏力、纳减、尿黄 1周 ,抽搐、呕吐咖啡样液体、意识障碍 3小时。拟重症肝炎、肝性脑病、上消化道出血 ,从当地医院转本院。患者入院前 1周稍感乏力 ,食欲下降 ,右上腹隐痛不适、尿黄 ,无恶心及呕吐 ,查肝功能异常 ,在当地按肝炎治疗 ,症状好转。入 1 medical records Summary Male, 36 years old. Because of fatigue, satisfied, urine yellow 1 week, convulsions, vomit coffee-like liquid, disturbance of consciousness 3 hours. Intensive care hepatitis, hepatic encephalopathy, upper gastrointestinal bleeding, transfer from the local hospital to the hospital. A week before admission, patients with weak feeling, loss of appetite, pain and discomfort of the right upper quadrant, urine yellow, no nausea and vomiting, check liver dysfunction, according to the local hepatitis treatment, the symptoms improved. Into