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女性,50岁。服青鱼胆后少尿、浮肿6天,于1990年1月25日12时急诊入院。患者于1月18日下午3时服“青鱼胆”一只,当晚10时感上腹不适,脐周疼痛伴恶心、呕吐、腹泻。至单位医院补液1500ml,仍呕吐不止,1月20日始尿量减少、浮肿。检查发现巩膜,皮肤黄染,尿蛋白++,血肌酐(Scr)3.9mg%,诊断为“青鱼胆中毒”、“中毒性肾炎”,经对症处理后虽尿量增加,但Scr 逐渐升至7.9mg%,GPT600u,恶心呕吐加重,按“急性肾功能衰竭”收住本院肾科治疗。体检及住院经过:血压160/100,脉搏76次,呼吸22次,体温37.2℃。发育正常,营养良好,神清合作,皮肤轻度黄染,无出血点及瘀斑点,浅表淋巴结不肿大。入院后当日在局麻下行CAPD 插管术,术后即行腹透治疗,同时服“保肾丸”。次日病人症状改善,能进早餐。腹透3天后Sct 降至5.8mg%,腹透一周后Scr2.5mg%～1.8mg%,基本痊愈出院。
Female, 50 years old. Served after the gall bladder oliguria, edema 6 days, at January 25, 1990 emergency admission. Patients at January 3 on the 18th served “blue carp gallbladder,” a feeling of 10 o’clock that night, abdominal discomfort, umbilical pain with nausea, vomiting, diarrhea. To the unit hospital rehydration 1500ml, still vomiting more than January 20 began to reduce urine output, edema. Scrotal sclera, skin yellow dye, urine protein ++, and serum creatinine (Scr) 3.9mg% were diagnosed as “herring gallbladder poisoning” and “toxic nephritis.” After experiencing symptomatic treatment, urine output increased but Scr gradually increased 7.9mg%, GPT600u, nausea and vomiting aggravating, according to “acute renal failure” admitted to our hospital kidney treatment. Physical examination and hospitalization after: blood pressure 160/100, pulse 76 times, breathing 22 times, body temperature 37.2 ℃. Normal development, good nutrition, clear cooperation, mild yellow skin, no bleeding and ecchymosis, superficial lymph nodes is not enlarged. On the day after admission, they underwent CAPD intubation at local anesthesia. After peritoneal dialysis, they were treated with “Bao Shen Wan”. The next day the patient’s symptoms improved, can enter breakfast. Sct dropped to 5.8mg% after 3 days of dialysis, Scr2.5mg% ~ 1.8mg% after one week of dialysis. The patients were basically discharged.