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患者男,70岁。因上腹不适、隐隐作痛半年入院。钡餐透视及胃镜检查均诊为胃窦癌,病理活检报告为胃窦粘膜腺癌。入院行胃癌根治术后,患者体温高达39.5℃,给予青霉素800万U、庆大霉素24万U、氨苄青霉素5g静滴3天,体温仍持续不退。查WBC12.6×10~9,N0.89,L0.11。行二次手术探查诊为十二指肠残端瘘,即停用上述抗生素,加用先锋霉素4g、丁胺卡那霉素0.6g、悉复欢200mg静滴,但患者体温仍高达39.2℃。复查WBC6.4×10~9,N0.89,L0.11。患者嗜睡,口干不欲饮,大便6～8次/d;舌绛红,体胖大,苔黄燥,脉数。中医诊为热邪伤阴,热入营血。经服清营汤加减两剂,体温开始下降,大便1次/d;服至第5天,体温及血像均恢复正常。
Patient male, 70 years old. Due to abdominal discomfort, faint pain six months admitted. Barium meal and gastroscopy were diagnosed as gastric cancer, biopsy reported gastric adenocarcinoma. After radical gastrectomy, the patient’s temperature was as high as 39.5 ° C, and penicillin 800 million U, gentamicin 240,000 U and ampicillin 5g were intravenously dripped for 3 days, and the body temperature remained unchanged. Check WBC12.6 × 10 ~ 9, N0.89, L0.11. The line of the second surgical exploration diagnosed as duodenal stump fistula, that is, the above-mentioned antibiotics, plus Pioneer 4g, amikacin 0.6g, Sifu Huan 200mg intravenous infusion, but the patient’s body temperature is still as high as 39.2 ℃. Review WBC6.4 × 10 ~ 9, N0.89, L0.11. Patients drowsiness, dry mouth do not want to drink, stool 6 to 8 times / d; tongue crimson, body fat, dry yellow fur, pulse number. Chinese medicine diagnosed as heat evil wounds, heat into the camp blood. After serving Qingying Decoction plus two, body temperature began to decline, stool 1 / d; serving until the 5th day, body temperature and blood were returned to normal.