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男患,41岁,因乏力、纳差、尿黄一周于1990年8月9日入院。既往有“乙肝”病史11年。查体:精神差,嗜睡,皮肤、巩膜中度黄染。视力正常。可见肝掌及蜘蛛痣。肝肋下未触及,肝区有叩击痛。腹水征(±)。实验室检查:肝功能:总胆红素121μmol/L,一分钟胆红素35.7μmol/L,胆固醇2.9mmol/L,总蛋白:70g/L、白蛋白33g/L、球蛋白37g/L,ALT28U,AST24U,PT22.3秒(对照14.2秒),血氨103μmol/L。乙肝三系检查均阳性。B 超:弥漫性肝损害,少量腹水。诊断为病毒性肝炎 HBsAg(+)慢性活动型并Ⅰ级肝昏迷。给予护肝、降黄及预防并发症等治疗。入院等10天,患者感左眼疼痛、畏光,枧物模糊,视力下降。查左眼:视力为感光,瞳孔对光反射迟钝角膜表面模糊,视房后有角膜沉着物(kp),房水混浊,虹膜前粘连。诊断为左眼继发性葡萄膜炎。加用全身及局部抗炎治疗。但视力逐渐下降至完全消失。九月十日左眼 B 超(用5兆赫探头)提示:左眼继发性视网膜部分脱离。住院四月,
Male, 41 years old, due to fatigue, anorexia, urinary yellow week in August 9, 1990 admitted. Past history of “hepatitis B” 11 years. Physical examination: poor spirit, lethargy, skin, sclera moderate yellow dye. Normal vision. Visible liver palms and spider nevus. Liver ribs have not touched, liver percussion pain. Ascites sign (±). Laboratory tests: Liver function: Total bilirubin 121μmol / L, one minute bilirubin 35.7μmol / L, cholesterol 2.9mmol / L, total protein 70g / L, albumin 33g / L, globulin 37g / ALT28U, AST24U, PT22.3 seconds (control 14.2 seconds), blood ammonia 103μmol / L. Hepatitis B three lines were positive. B super: diffuse liver damage, a small amount of ascites. Diagnosis of viral hepatitis HBsAg (+) chronic active and grade Ⅰ hepatic coma. Give liver protection, yellow and prevention of complications such as treatment. Admission for 10 days, the patient felt pain in the left eye, photophobia, blurred vision, decreased visual acuity. Check the left eye: visual acuity, the pupil light reflex obscure Corneal surface blurred, depending on the cornea after the atria (kp), aqueous humor, adhesion before the iris. Diagnosis of left-sided secondary uveitis. Plus systemic and local anti-inflammatory treatment. However, visual acuity gradually decreased to completely disappear. September 10 left B ultrasound (with 5 MHz probe) Tip: Left part of the secondary retinal detachment. Hospitalized in April,