论文部分内容阅读
患者男性,68岁,农民。因畏寒、发热20余天伴咳嗽、咳少量白色痰于1995年6月14日入院。无咯血、胸痛,曾在当地医院予洁霉素、丁胺卡那霉素抗炎治疗,3天后咳嗽咳痰消失,但体温呈弛张型热,高达39℃,尤以午后明显,无盗汗。20年前有血吸虫病史,否认肝炎、结核病史。体检:发育中等,慢性病容,皮肤、巩膜无黄染,未见痴蛛痣及肝掌,浅表淋巴结无肿大。心肺听诊正常。腹平软,无压痛、反跳痛,未及包块,肝肋下刚及,质中,轻触痛,肝区有叩击痛,Murphys征阳性,脾肋下2cm,质中无触痛,移动性浊音阴性,肠鸣音正常。实验室检查:血Hb 102g/L,WBC 3.1×10~9/L,N 0.69,L 0.24。肝功能ALB 29.2g/L,GLO 33.5g/L,ALT 68 IU/L,ALP 176IU/L,GTP 224IU/L。蛋白
Male patient, 68 years old, farmer. Due to chills, fever more than 20 days with cough, cough and a small amount of white sputum on June 14, 1995 admission. No hemoptysis, chest pain, in the local hospital to lincomycin, amikacin anti-inflammatory treatment, cough and sputum disappeared after 3 days, but the body temperature was relaxation Zhang heat, up to 39 ℃, especially in the afternoon obviously, no night sweats . Schistosomiasis had a history of 20 years ago, denied the history of hepatitis and tuberculosis. Physical examination: moderately developed, chronic disease, skin, sclera no yellow dye, no spider nevus and liver palms, superficial lymph nodes without swelling. Cardiopulmonary auscultation normal. Abdominal tenderness, no tenderness, rebound tenderness, not mass, just under the liver ribs, quality, touch the pain, liver percussion pain, Murphys sign positive, spleen ribs 2cm, no tender quality , Mobility voiced negative, normal bowel sounds. Laboratory tests: blood Hb 102g / L, WBC 3.1 × 10 ~ 9 / L, N 0.69, L 0.24. Liver function ALB 29.2 g / L, GLO 33.5 g / L, ALT 68 IU / L, ALP 176 IU / L, GTP 224 IU / L. protein