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病人男,25岁,因车祸摔伤头面部2小时入院。入院查体:T:37℃Bp:10/8kPa,昏迷状态,GCS评分7分,右瞳孔直径6mm,光反应尺钝,左瞳孔直径5mm,光反应灵敏,颈软,心、肺、腹正常,四肢肌张力不高,活动正常。颅脑CT:左枕叶、右额叶脑挫裂伤、颅内积气。入院诊断:左枕叶、右额叶脑挫裂伤、颅底骨折。入院后给予甘露醇脱水、止血、消炎治疗。入院后44小时病人苏醒,GCS评分12分,生命指征平稳,双瞳孔等大等圆GLU8.5mmol/L;Na+142mmol/L;K+4.44mmol/L;Ca~2+2.15mmol/L;C(?)101mmol/L。入院后第10天,病人病情突然加重,呈昏迷状态,GCS评分8分,T:38.9℃Bp:18/kPa,右瞳孔直径工
Male patient, 25 years old, was injured in a car accident head face 2 hours admitted. Admission examination: T: 37 ℃ Bp: 10 / 8kPa, unconsciousness, GCS score 7 points, right pupil diameter 6mm, light reaction obturator pupil, left pupil diameter 5mm, sensitive to light, neck soft, heart, lung, , Limb muscle tension is not high, normal activity. Brain CT: left occipital lobe, right frontal lobe contusion, intracranial gas. Admission diagnosis: Left occipital lobe, right frontal lobe contusion, skull fracture. After admission to give mannitol dehydration, bleeding, anti-inflammatory treatment. At 44 hours after admission, the patient was awake, the GCS score was 12, and the vital signs were stable. The average pupillary blood volume of GLU was 8.5mmol / L, Na + 142mmol / L, K + 4.44mmol / L, Ca 2+ + 2.15mmol / L ; C (?) 101mmol / L. On the 10th day after admission, the patient’s condition suddenly increased and became unconscious. The GCS score was 8 points, T: 38.9 ℃ Bp: 18 / kPa, and the right pupil diameter