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病例,女,56岁,于1982年4月4日入院。患者19年来有渐进性怕冷、乏力、活动减少、食欲不振、全身浮肿及声音嘶哑等。多年来按慢性肾炎治疗无效;近二月来淡漠嗜睡,5日来意识模糊,口唇发绀,既往体健。体检:T34℃,P52次,R12次,BP86/50。轻度昏迷,口唇和指甲明显紫绀。皮肤干躁,中度非凹陷性浮肿。头发枯黄。两侧瞳孔等大,直径4mm,对光反应迟钝。甲状腺不肿大。心浊音界轻度向左扩大,心律齐,心音低钝,无病理性杂音。两肺呼吸音低。四肢肌张力减低。膝反射未引出。克氏征(-),双侧巴氏征(+)。检验:血:RBC 2.8×10~(12)/L,Hb75g/L,WBC 8.4
Case, female, 56 years old, admitted to hospital on April 4, 1982. Patients 19 years have progressive cold, fatigue, decreased activity, loss of appetite, body edema and hoarseness and so on. Over the years by chronic nephritis treatment ineffective; indifference to drowsiness in the past two months, on the 5th to fuzzy, lips cyanosis, previous physical health. Physical examination: T34 ℃, P52 times, R12 times, BP86 / 50. Mild coma, obvious cyanosis of lips and nails. Dry skin, moderate non-depression edema. Brown hair. Pupils and other large on both sides, diameter 4mm, unresponsive to light. Thyroid does not enlarge. Mild diastolic heart to the left to expand, heart rate Qi, heart sound low blunt, no pathological noise. Low breath sounds in both lungs. Limb muscle tension decreased. Knee reflex did not lead. Kirschner sign (-), bilateral Pakistan’s sign (+). Test: blood: RBC 2.8 × 10 ~ (12) / L, Hb75g / L, WBC 8.4