1病例报告患者女,67岁。因乏力、胃灼热1年,多尿、恶心2个月,意识模糊5天就诊。患者1年前无诱因反复出现乏力、胃灼热、上腹不适、便秘等症状,给予抑酸、通便等治疗,症状未完全缓解。2个月前上述症状加重,且出现多饮多尿、恶心呕吐、厌食伴嗜睡,当地医院给予抗凝、扩血管等治疗无效。5天前出现意识模糊、谵妄,遂转诊至上级医院。查体:体温、脉搏、呼吸、血压均正常。神志不清,查体欠合作,对答不切题,余未见明显异常体征。 A case report patient female, 67 years old. Due to fatigue, heartburn 1 year, polyuria, nausea 2 months, 5 days ambiguous treatment. One year ago, there was no incentive for patients to repeatedly fatigue, heartburn, upper abdominal discomfort, constipation and other symptoms, give acid suppression, laxative and other treatment, the symptoms are not completely relieved. 2 months ago, the symptoms worsened, and more drink more urine, nausea and vomiting, anorexia with lethargy, local hospital to anticoagulant, vasodilator and other treatment is invalid. 5 days ago, confusion, delirium, then referral to superior hospital. Physical examination: body temperature, pulse, respiration, blood pressure are normal. Consciousness, physical examination owed cooperation, no answer to questions, I have no obvious signs of abnormalities.