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患者,女,63岁,该患以发热,无力,消瘦为主诉入院。查体:血压16.0/10.7kPa、脉搏90次/分,体温37.2℃。听诊两肺呼吸音粗糙外,余正常。胸部X线平片提示:两肺上野有不规则片状阴影。诊断为浸润型肺结核活动期。实验室检查血、尿、便常规正常、痰TB Gaffiky V,肝功、HBsAg正常。住院抗结核化疗一个月后,发现患者不能进食,病人主诉有明显吞咽困难,少许进食后反复呕吐,为胃内容物。病人开始多饮,每日饮水量为4000ml—5000ml,并且多尿每日3000m1—4000ml,多夜尿。遂日消瘦,头发变脆,脱落、变白。皮肤弹性差,变薄.手足中指甲粗糙,断裂,反甲。开始反复发作性手足抽搐,肌力逐渐
Patient, female, 63 years old, admitted to hospital with fever, weakness and weight loss. Physical examination: blood pressure 16.0 / 10.7kPa, pulse 90 beats / min, body temperature 37.2 ℃. Auscultation two lungs rough breathing sounds, more than normal. Chest X-ray film tips: the two lungs Ueno irregular sheet shadow. Diagnosis of invasive pulmonary tuberculosis activity. Laboratory tests of blood, urine, they are routine, sputum TB Gaffiky V, liver function, HBsAg normal. One month after hospitalization for anti-tuberculosis chemotherapy, the patient was found unable to eat. The patients complained of obvious swallowing difficulties and little vomiting after eating, which was the stomach contents. The patient began to drink more, drinking daily volume of 4000ml-5000ml, and polyuria daily 3000m1-4000ml, more nocturia. Then thin, hair brittle, fall off, white. Poor skin elasticity, thinning. Rough, broken nails in hands and feet, anti-A. Repeated episodes of hand-foot twitch, muscle strength gradually