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1例93岁女性患者因反复呕吐、进食困难入院,肾功能检查示血清肌酐90μmol/L,尿素10 mmol/L。给予复方氨基酸注射液500 ml和丙氨酰谷氨酰胺注射液100 ml静脉滴注,1次/d。入院第5天患者血清肌酐122μmol/L,尿素5 1 mmol/L,未予特殊处理。第12天血清肌酐120μmol/L,尿素62 mmol/L,K~+6.0 mmol/L,Na~+157 mmol/L,Cl~-134 mmol/L。患者出现神志模糊。停用复方氨基酸和丙氨酰谷氨酰胺注射液,同时控制钾、钠和补液量。4 d后因患者病情再次给予肠外营养液,但仅静脉滴注复方氨基酸注射液500 ml/d,共1周。复查血清肌酐126μmol/L,尿素29.7 mmol/L。此后患者尿素水平未再升高。
A 93-year-old female patient was admitted to hospital due to repeated vomiting and had difficulty eating. Kidney function tests showed serum creatinine 90 μmol / L and urea 10 mmol / L. Give compound amino acid injection 500 ml and alanyl glutamine injection 100 ml intravenous infusion, 1 time / d. Serum creatinine was 122 μmol / L on day 5 and 51 mmol / L of urea on the 5th day after admission. No special treatment was given. Serum creatinine 120 μmol / L, urea 62 mmol / L, K ~ + 6.0 mmol / L, Na ~ + 157 mmol / L, Cl ~ -134 mmol / L on the 12th day. Patients appear ambiguous. Disable compound amino acids and alanyl glutamine injection, while controlling potassium, sodium and fluid volume. After 4 days, patients were given parenteral nutrition again, but only compound infusion of 500 mg / d intravenous infusion for 1 week. Review of serum creatinine 126μmol / L, urea 29.7 mmol / L. After the patient’s urea levels did not rise again.