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1 病例报告患者女.18岁.因发热6天伴胸闷、气促、腹痛、腹胀、尿少、谵语、行为异常3天在外院经激素、抗生素、利尿剂治疗后神志好转入本院治疗.查体:BP16/10.7kPa,唇绀,双肺无罗音.心界扩大,心率88次/分、律齐.心尖区S_3,无杂音.肝助下6cm,质中压痛,脾肋下5cm.实验室检查:Hb78g/L,WBC16.6×10~9/L.血沉53mm/h.尿蛋白痕迹.肝酶、心肌酶、肌酐、尿素氮均明显升高.心脏B超提示少量心包积液.心脏三位片示心影扩大,右侧胸膜反应.心电图示T波倒置.入院诊断为病毒性全心炎,心力衰竭Ⅲ度.给予抗炎、利尿、扩血管、强心药物治疗,同时每日静滴地塞米松10mg.2天后病情显著好转,上述症状完全缓解,仅有轻微膝关节酸痛,肝、脾肋下及边.肝酶、心肌酶、肾功能基本正常.白细胞及血沉下降.继续治疗1周后停用激素,其余治疗不变.1周
1 case report The patient was female .18 years old. Due to fever for 6 days with chest tightness, shortness of breath, abdominal pain, abdominal distension, oliguria, rhetoric, abnormal behavior 3 days in the hospital after hormone, antibiotics, diuretics, Physical examination: BP16 / 10.7kPa, cyanotic cyanosis, lungs without rales. Heart expanded, heart rate 88 beats / min, law Qi. Apex S_3, no noise. Liver assist 6cm, 5cm. Laboratory tests: Hb78g / L, WBC16.6 × 10 ~ 9 / L. Sputum 53mm / h. Urine protein traces. Liver enzymes, myocardial enzymes, creatinine, urea nitrogen were significantly increased. Effusion .Three heart showed cardiac enlargement, right pleural reaction.Electrocardiogram showed T wave inversion .Admitted to the hospital for the diagnosis of viral total heart inflammation, heart failure Ⅲ degree.Anti-inflammatory, diuretic, vasodilator, cardiac drug therapy , While daily intravenous dexamethasone 10mg 2 days after the disease was significantly improved, the symptoms completely relieved, only mild knee pain, liver, spleen ribs and the side. Liver enzymes, myocardial enzymes, renal function was normal. White blood cells and Sputum decline continued treatment for 1 week after the withdrawal of steroids, the remaining treatment unchanged .1 week