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例1,女,19岁。以消瘦、纳差、尿少、全身衰竭、卧床不起入院。心肺无异常,Hb60g/L,尿蛋白(+),血沉110mm/h,BUN23.3mmol/L,Cr707.0mmol/L,CO_2CP20.9mmol/L。肾脏 B超示:双肾上极多发性囊性改变,可疑肾结核、多囊肾。经肾盂穿刺造影,排除多囊肾。结合临床症状拟诊:肾结核致肾功衰竭。给予抗结核等对症治疗,一月后患者症状明显改善,食量增加,体力恢复,能下床活动。肾功趋于好转。BUN13.5mmol/L,Cr309.4mmol/L,CO_2CP23.3mmol/L。为确诊肾脏情况,在病情稳定后做了肾脏 CT 检查。检查中静脉注射了76%的泛影葡胺40ml(碘过敏试验阴性)。CT 检查后第二天,患者感全身不适,厌食、乏力、尿少。第三天血压下降、无尿、昏迷、继而呼吸心跳停止,抢救无效死亡。当日查血电解
Example 1, female, 19 years old. To weight loss, anorexia, oliguria, systemic failure, bedridden admission. Hb60g / L, urinary protein (+), erythrocyte sedimentation rate 110mm / h, BUN23.3mmol / L, Cr707.0mmol / L, CO_2CP20.9mmol / L. Kidney B ultrasound showed: extremely multiple cystic menopause, suspicious renal tuberculosis, polycystic kidney disease. The pelvis puncture angiography, excluding polycystic kidney disease. Combined with clinical symptoms to be diagnosed: renal failure caused by renal tuberculosis. Give antituberculosis and other symptomatic treatment, patients with symptoms improved significantly after January, food intake, physical recovery, to get out of bed activity. Renal function tends to improve. BUN13.5mmol / L, Cr309.4mmol / L, CO_2CP23.3mmol / L. To confirm the condition of the kidneys, kidney CT examination was performed after the condition was stable. Intravenous injection of 76% of the diatrizoate 40ml (negative iodine allergy test). The day after the CT examination, the patient was feeling unwell, anorexia, fatigue, oliguria. The third day of blood pressure, no urine, coma, and then stop breathing and resuscitation died. The day of blood electrolysis