病历摘要患儿女性,2岁,住院号158540。以发热、咳嗽、气喘3天,无尿12小时急诊入院。患儿于生后4月曾因腹泻脱水,在外应用超量庆大霉素而致持续5日无尿,住我院诊断为急性肾衰,经腹膜透析等近期治愈。自然喂养,平时尚健,家中无何特殊病史。体格检查:T39.3℃,P160次/分,R60次/分。方颅,枕后脱发。热性病容,明显缺氧状态。咽红,扁桃体Ⅰ°肿大。颈软,胸部可见郝氏沟及肋骨串珠。心音减弱,心尖区可闻及Ⅱ—Ⅲ°SM,两肺可闻及多数细湿罗音。腹胀、肝肋下6.5cm、脾大2cm,肾区叩痛(±),克氏征及巴氏征均(-),浮肿(-)。实验室检查:血象白细胞17,600/mm~3,中性64%,淋巴36%。尿蛋白(+++),定量1.5g/24小时。镜检 Medical record Summary Children and women, 2 years old, hospital number 158540. To fever, cough, asthma 3 days, 12 hours without urine emergency admission. Children born in April after dehydration due to diarrhea, external use of gentamicin overdose for 5 days without urine, live in our hospital diagnosed as acute renal failure, peritoneal dialysis and other recent cure. Natural feeding, usually healthy, no special medical history at home. Physical examination: T39.3 ℃, P160 beats / min, R60 beats / min. Square cranial, occipital hair loss. Fever disease, obvious hypoxia. Throat, tonsil I ° enlargement. Neck soft, visible Hao’s ditch and ribs on the chest. Heart sounds weakened, apex area can be heard and Ⅱ-Ⅲ ° SM, lungs can be heard and most of the fine wet rales. Abdominal distension, liver ribs 6.5cm, splenomegaly 2cm, renal area percussion pain (±), Kirschner sign and Pakistan sign (-), edema (-). Laboratory tests: blood leukocytes 17,600 / mm ~ 3, 64% neutral, lymph 36%. Urine protein (+++), quantitation 1.5g / 24 hours. Microscopic examination