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患者,男,36岁。因反复蛋白尿,颜面浮肿2年余,在广西区医院诊断为慢性肾炎;慢性尿毒症。血液透析半年后,转我院继续治疗。每次血透3次,每次4小时。入院一周,每次血透的第1小时,病人均感下肢不适,足背酸麻,经局部按摩可见好转,到第3小时,下肢不停移动,足背酸胀麻木加重,难以忍受,按摩无效。静注安定5mg,症状稍有好转,20分钟后再发且逐渐加剧。停止血透后,症状明显改善。既往无类似病史及家族史。神清,精神欠佳,贫血貌。心尖搏动弥散心界向左下扩大,心率90次/分,神经系统检查无阳性征。实验室检查:Hb60g/L,RBC2.12×10~6/L,
Patient, male, 36 years old. Due to repeated proteinuria, facial edema more than 2 years, diagnosed in Guangxi District Hospital for chronic nephritis; chronic uremia. Six months after hemodialysis, transfer to our hospital for further treatment. Each hemodialysis three times, each time 4 hours. The first hour of admission, each hemodialysis in the first hour, the patient was feeling lower extremity discomfort, dorsal rashes, the local massage can be improved to the first 3 hours, lower extremity kept moving, dorsal acidosis numbness, unbearable, massage invalid. Intravenous stability 5mg, the symptoms slightly improved, and then gradually increased after 20 minutes. After hemodialysis stopped, the symptoms improved significantly. No similar past history and family history. Clear, poor spirit, anemia appearance. Apex beating heart dispersion to expand to the lower left heart rate 90 beats / min, neurological examination no positive sign. Laboratory tests: Hb60g / L, RBC2.12 × 10 ~ 6 / L,