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患者,男,49岁.意识不清1小时于1997年4月12日15时50分入院.患者1小时前讲课时突然剧烈头痛、眩晕,视物模糊,随即跌倒后意识不清,小便失禁.有高血压病6年,长期口服复方降压片,BP维持在20/13.5kPa.查体:BP40/20kPa,浅昏迷,脉搏洪大有力,呼吸急促,面色潮红,颈软,眼球震颤,双侧瞳孔等圆约3mm,对光反射迟钝,两肺底闻及细湿罗音,心率120次/分,心尖区闻及奔马律,A_2亢进,腹软,肝右肋下1.5cm,四肢肌张力增强,巴氏征(+).眼底见视神经乳头水肿.初步诊断:高血压病Ⅲ期,高血压危象,高血压脑病.
Patient, male, 49 years old Unconsciousness 1 hour Admission at 15:50 on April 12, 1997. Patient 1 hour ago when the lecture suddenly severe headache, dizziness, blurred vision, then fall unconscious, incontinence .Hypertension for 6 years, long-term oral compound antihypertensive tablets, BP maintained at 20 / 13.5kPa. Physical examination: BP40 / 20kPa, shallow coma, powerful pulse, shortness of breath, flushing, neck soft, nystagmus, Bilateral pupil round about 3mm, slow light reflex, the lungs at the end of smell and fine wet rales, heart rate 120 beats / min, apex area smell gallop, A_2 hyperthyroidism, abdominal soft, right rib 1.5cm, Limb muscle tone enhancement, Pakistan’s sign (+) .The fundus optic nerve head edema.Preliminary diagnosis: hypertension stage Ⅲ, hypertensive crisis, hypertensive encephalopathy.