患者女,82岁。腹痛腹泻3d,头昏1d于2014年3月17日入院。3d前,患者因不洁饮食后开始出现腹痛不适,主要为脐周隐痛不适,感轻微恶心,无呕吐,后开始出现腹泻黄色稀水样便,约3~5次/天,1000ml/d;畏寒、发热,无咳嗽、咯痰,无尿频、尿急、尿痛等。既往有糖尿病病史20多年,目前口服格列美脲1mg,每天1次,空腹血糖控制在7.5mmol/L以下。体格 Female patient, 82 years old. Abdominal pain and diarrhea 3d, dizziness 1d was admitted on March 17, 2014. 3d, the patient began to appear after abdominal pain discomfort due to unclean diet, mainly for the umbilical pain and discomfort, a slight nausea, no vomiting, diarrhea began to appear yellow watery stool, about 3 to 5 times / day, 1000ml / d; Chills, fever, no cough, expectoration, no urinary frequency, urgency, dysuria and so on. Past history of diabetes more than 20 years, the current oral glimepiride 1mg, 1 day, fasting blood glucose control in 7.5mmol / L or less. physique