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1 病例介绍 患者男性,61岁,因口渴、多饮、多尿3个多月于1996年2月14日入院。患者于3个多月前开始口渴,多饮,每天饮2热水瓶开水,伴多尿,每天排尿量5000ml左右,自觉乏力,纳差。当地医院诊为“尿崩症”,予双氢克尿噻等药物治疗,无明显好转而转入本院。查体:体温36.3℃,脉搏84次/分,呼吸20次/分,血压16/10kPa,神志清,慢性病容,浅表淋巴结未及,两肺呼吸音清,未闻及干湿罗音,心脏无殊,腹部无殊。辅助检查:血红蛋白1078/L,红细胞340×10~(12)╱L,白细胞9.8×10~9/L,中性0.77,淋巴0.23,血小板442×10~9/L。尿比重1.005。血沉40mm/h。血电解质:血清钙3.00mmol╱L,血清磷0.67mmol/L。胸片示左肺下野内带见5cm×5cm大小块影,考虑左肺癌。胸部CT示左肺下叶外侧段恶性肿瘤。纤维支气管镜活检病理报告为:(左下叶管口)鳞癌。入院后诊断为左肺鳞癌。确诊后转胸外科手术治疗,行左下肺癌根治术。术后患者口渴,多饮,多尿症状消失,复查血清电解质,尿比重均恢复正常出
1 Case presentation The patient was a 61-year-old man. He was admitted to hospital on February 14, 1996 because of thirst, frequent drinking and polyuria. The patient began to thirsty more than 3 months ago, drink more, drink 2 hot water bottles every day, with polyuria, daily urination volume of about 5000ml, consciously fatigue, anorexia. The local hospital diagnosed as “diabetes insipidus” and treated with drugs such as dihydrochlorothiazide, which was transferred to our hospital without obvious improvement. Physical examination: body temperature 36.3°C, pulse 84 beats/min, respiratory rate 20 breaths/min, blood pressure 16/10 kPa, clear-mindedness, chronic disease, superficial lymph nodes, respiratory sounds in both lungs, unheard of wet and dry rales, No special heart, no abdomen. Supplementary examination: hemoglobin 1078/L, red blood cells 340×10 12 ╱L, white blood cells 9.8×10 9/L, neutral 0.77, lymphoid 0.23, platelets 442×10 9/L. Urine specific gravity 1.005. ESR 40mm/h. Blood electrolytes: serum calcium 3.00 mmol ,L, serum phosphorus 0.67 mmol/L. The chest radiograph shows that the size of the 5cm×5cm patch is seen in the left lower lung region, taking into account the left lung cancer. Chest CT showed malignant tumors of the left lower lobe. Fiberoptic bronchoscopy biopsy pathology reports: (left lower leaf orifice) squamous cell carcinoma. After admission, diagnosed with left lung squamous cell carcinoma. After diagnosis, the patient was transferred to thoracic surgery and left lung cancer surgery was performed. After the patient thirsty, drink more, polyuria symptoms disappeared, review serum electrolytes, urine specific gravity returned to normal