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病历摘要男患,65岁。因腹胀、尿少、周身黄染3天,突然失明2小时,于1986年11月7日入院。既往肝硬化10年,曾发生过肝性脑病。查体:面包灰暗,神志清,精神萎靡,巩膜及周身皮肤黄染,上胸部有多个蜘蛛痣,肝掌(+)。心肺正常,腹部膨隆,可见腹壁静脉曲张,肝上界位右锁中线上第5肋间,肋下未触及,脾肋下3.0cm,腹部移动性浊音(+),下肢浮肿。实验室检查:白细胞3.2×10~9/L,血小板50×10~9/L,血清胆红素54μmol/L,谷丙转氨酶160~u,白蛋白:球蛋白为2.6/4.8,甲胎蛋白(-)。入院第2天起躁动不安,语言
Male patient history, age 65. Due to abdominal distension, oliguria, whole body yellow dye 3 days, suddenly lost 2 hours, on November 7, 1986 admission. Past cirrhosis 10 years, had had hepatic encephalopathy. Physical examination: bread gloomy, conscious, apathetic sclera and whole body skin yellow dye, the upper chest has multiple spider nevus, liver palms (+). Cardiopulmonary normal, bulging belly, visible abdominal wall varicose veins, the upper right hepatic border lock on the 5th right intercostal space, the ribs did not touch the spleen ribs 3.0cm, abdominal dullness (+), lower extremity edema. Laboratory tests showed that leukocytes 3.2 × 10 ~ 9 / L, platelets 50 × 10 ~ 9 / L, serum bilirubin 54μmol / L, alanine aminotransferase 160 ~ u, albumin: globulin 2.6 / 4.8, (-). On the 2nd day of hospitalization restlessness, language