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男,32岁。1982年4月患急性黄疸型肝炎,半月后腹胀,下肢浮肿,曾用10％葡萄糖、肌苷、肝泰乐静滴,并每天静滴地塞米松10mg共20天。病情加重,发病第43天入院。体温37.6℃,脉搏62次,呼吸22次,血压100/60,神志清,消瘦,怠倦,胸前有多粒蜘蛛痣,“肝掌”征(+),巩膜皮肤深度黄染,双肺呼吸音减弱,肝右肋下未及、剑突下2cm、质中度,脾左肋下仅及,腹部叩诊有转移性浊音,双下肢有明显水肿,进院后体温在38.4～39.5℃之同,头痛,头晕,大便次数增多,血丝便,咳嗽增多,痰中带血。入院第6天有精神症状,无故脱衣,答非所问,呼吸深长,2天后神志不清,腹水迅速增加,第10天呼吸、脉搏加速,呈深昏迷,潮式呼吸,晚上呼吸先停心跳后止。血象:白细胞11,400,中性90％,淋巴10％,红细胞310万,血红蛋白60％,出凝血时间稍延长,血小板7万。血生化检查无异常。
Male, 32 years old. April 1982 suffering from acute jaundice hepatitis, half a month after abdominal distension, lower extremity edema, once with 10% glucose, inosine, Gantrez intravenous infusion, and daily intravenous dexamethasone 10mg for 20 days. Exacerbations, onset of admission on the 43rd day. Body temperature 37.6 ℃, pulse 62 times, breathing 22 times, blood pressure 100/60, consciousness clear, weight loss, fatigue, chest multi-grain spider nevus, "liver palpitations sign (+), scleral skin depth yellow dye, Breathing sound weakened, the right lower quadrant of the liver was inferior, the xiphoid 2cm, moderate quality, the spleen left rib only and perineal percussion metastatic dullness, both lower extremities have significant edema, after admission the body temperature at 38.4 ~ 39.5 ℃ With the headache, dizziness, increased stool frequency, bloodshot eyes, increased cough, bloody sputum. Admitted to the first 6 days of mental symptoms, no reason to strip, non-questioning, deep breathing, 2 days unconsciously, ascites increased rapidly, the first 10 days of breathing, pulse acceleration, was deep coma, tidal breathing, breathing at night before stopping heartbeat. Blood: white blood cells 11,400, 90% neutral, lymphatic 10%, erythrocytes 3.1 million, hemoglobin 60%, a little longer clotting time, platelet 70,000. No abnormal blood biochemical examination.