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我院1985年11月间收治一例服用黄丹(Pb_2O_3)治疗癫痫造成急性铅中毒,而临床上误诊为病毒性肝炎,报告如下: 患者,男性,17岁,因频繁呕吐,腹痛二周于1985年11月9日入院。患者有癲痫病史近一年。入院前四周服用治痫单方(内含有黄丹),每次10g,每日2次,用药当日即腹泻,日达3～4次,皆为黄色稀便。入院前两周腹泻已止,但仍有恶心,呕吐,伴下腹部阵发性疼痛。入院前一周前述症状加重,两眼发黄,查肝功能有损害,遂以病毒性肝炎,急性黄疸型转入我院。检查:T36℃,P76次,R18次,BP110/80,神清,贫血貌,皮肤巩膜轻度黄染,下腹部压痛,肝脏肋下刚及,质软,无压痛,肠鸣音减低,余正常。血Hb 100g/L,RBC3.4×10~(12)/L,WBC 6.4×10~9/L,N 65％,L 35％,M 2％, 网织红细胞0.5％,BPC 110×10~9/L,PT16s,对照15s,肝功能:1120u,VDB双相(+),TTT 6u,ZnTT 8u,SB 2.2mg％,SOPT 160u。尿蛋白(+),透明管型(++),RBC少许,WBC少许,尿三胆(+)。Cr 2.0mg％,BUN 21mg％。
In our hospital in November 1985 admitted a case of taking Huangdan (Pb_2O_3) treatment of epilepsy caused acute lead poisoning, but clinically misdiagnosed as viral hepatitis, the report is as follows: Patients, male, 17 years old, due to frequent vomiting, abdominal pain two weeks in 1985 November 9, admission. The patient has a history of epilepsy for nearly a year. Four weeks before admission epilepsy unilateral (containing Huang Dan), each 10g, 2 times a day, the day of medication that is diarrhea, up to 3 to 4 times, all yellow loose stools. Two weeks before admission, diarrhea has stopped, but there is still nausea and vomiting with paroxysmal abdominal pain. One week before admission, the symptoms worsened, yellow eyes, check liver function damage, then to viral hepatitis, acute jaundice into our hospital. Check: T36 ℃, P76 times, R18 times, BP110 / 80, Shen Qing, anemia appearance, skin scleral mild yellow dye, tenderness under the abdomen, the ribs just below the liver, soft, no tenderness, bowel sounds reduced, normal. Blood Hb 100g / L, RBC 3.4 × 10-12 / L, WBC 6.4 × 10-9 / L, N 65%, L 35%, M 2%, reticulocyte 0.5%, BPC 110 × 10 ~ 9 / L, PT16s, control 15s, liver function: 1120u, VDB biphasic (+), TTT 6u, ZnTT 8u, SB 2.2mg%, SOPT 160u. Urine protein (+), clear tube (++), RBC a little, a little WBC, urinary San gall (+). Cr 2.0 mg%, BUN 21 mg%.