患者吴某,男,38岁。因外伤后左髋关节疼痛,行走困难入院。查体:左下肢肌肉萎缩,短缩,髋关节活动受限。心肺正常,Bp:18/12kpa,x线片示:左髋关节半脱位,股骨头坏死,血尿常规、血生化、肝功均正常,血型“A”。临床诊断:左股骨头无菌坏死,左髋关节半脱位。经全科讨论行全髋关节人工关节置换术。术中输“A”型血700ml,当时,出现烦躁,静点中加入地塞米松10mg,Bp13.3/8kpa,p100次/分,面色苍白。当晚又输“A”型血400ml。术后24小时无尿,给予20%甘露醇250ml注入后自行排尿约500ml,尿色呈酱油色。旦病人出现恶心,呕吐,BP21.3/13.3kpa,静注速尿80mg后仍无尿。此时查尿常规,蛋白(卅)。白细胞2～4,红细胞满视野。血红蛋白83.9g/L,血白细胞17.5×10~9/L,N 0.92,尿比重1.032,血肌酐407.8umol/L,尿素氮16.56mmol/L,术后第三天又输“A”型血 200ml输后 Patient Wu, male, 38 years old. Left hip pain due to trauma, walking difficulties admitted. Physical examination: left lower extremity muscle atrophy, shortening, limited hip activity. Cardiopulmonary normal, Bp: 18 / 12kpa, x-ray showed: left hip subluxation, femoral head necrosis, hematuria, blood biochemistry, liver function were normal, blood type “A ”. Clinical diagnosis: aseptic necrosis of the left femoral head, left hip subluxation. After the general discussion line total hip arthroplasty. Intraoperative transfusion “A” type blood 700ml, then, there was irritability, intravenous dexamethasone 10mg, Bp13.3 / 8kpa, p100 beats / min, pale. The same night lost “A” type blood 400ml. 24 hours after anuria, giving 20% ​​mannitol 250ml after injection of about 500ml of urine, urine was soy sauce color. Once the patient nausea, vomiting, BP21.3 / 13.3kpa, intravenous furosemide 80mg still no urine. Urine routine check at this time, protein (卅). Leukocytes 2 ~ 4, full of red blood cells field of vision. Hemoglobin 83.9g / L, white blood cells 17.5 × 10 ~ 9 / L, N 0.92, urine specific gravity 1.032, serum creatinine 407.8umol / L, urea nitrogen 16.56mmol / L, Blood 200ml after the loss