Funabiki Y, Tatsukawa H, Ashida K, Matsubara K, Kubota Y, Uwatoko H, Kitamura K
Department of Internal Medicine, Kyoto City Hospital, Kyoto.
Intern Med. 1998 Nov;37(11):958-61. doi: 10.2169/internalmedicine.37.958.
A 69-year-old man with chronic alcoholism was admitted to our hospital due to disturbance of consciousness and oliguria. Emergency laboratory examination revealed metabolic acidosis, hypoglycemia, hyponatremia, mild liver dysfunction, acute renal failure and rhabdomyolysis. After administration of fluids and nutrients and continuous hemodiafiltration, he recovered from all signs and symptoms except for disturbance of consciousness after 7 days. Since severe hypophosphatemia persisted, we administered adequate phosphates, and then his level of consciousness normalized. We discuss the relationships among alcohol abuse, hypophosphatemia and disturbance of consciousness, and recommend that hypophosphatemia be considered a potential cause of disturbance of consciousness in alcoholic patients.
一名69岁的慢性酒精中毒男性因意识障碍和少尿入住我院。急诊实验室检查显示代谢性酸中毒、低血糖、低钠血症、轻度肝功能障碍、急性肾衰竭和横纹肌溶解。在给予液体和营养物质并进行持续血液透析滤过治疗后，7天后除意识障碍外，他的所有体征和症状均已恢复。由于严重低磷血症持续存在，我们给予了足够的磷酸盐，随后他的意识水平恢复正常。我们讨论了酒精滥用、低磷血症和意识障碍之间的关系，并建议将低磷血症视为酒精性患者意识障碍的潜在原因。
