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患男,29岁。以发热、头痛、间歇性抽搐6周,加重3d收住。入院前曾在外院按病毒性脑炎、肝昏迷治疗4周无效而转院。既往于1994年在外院因肝硬变、脾功能亢进,行脾切除手术。查体:T38℃,P80次/min,BP14/7kPa。神志清,慢性病容。未见蜘蛛痣,可见肝掌。巩膜无黄染,颈有抵抗感。心肺阴性。肝肋下未及,未见腹壁静脉曲张,腹部移动性浊音阴性。四肢肌力、肌张力正常。扑翼样震颤阴性,双侧踝阵挛阴性,巴彬斯基征阴性。入院后继续按肝昏迷治疗2周,病情无好转,仍发热(38℃左右),剧烈头痛,伴有恶心、呕吐,自
Male, 29 years old. To fever, headache, intermittent seizures for 6 weeks, increased 3d admitted. Before admission in the outer court by viral encephalitis, liver coma treatment invalid for 4 weeks and transferred. Past in 1994 in the hospital due to cirrhosis, hypersplenism, splenectomy surgery. Physical examination: T38 ℃, P80 times / min, BP14 / 7kPa. Conscious, chronic illness. No spider nevus, visible liver palms. Sclera no yellow dye, the neck has a sense of resistance. Heart-lung negative. Hepatic inferior collateral, no abdominal varicose veins, abdominal movement dullness negative. Limb muscle strength, muscle tone normal. Flapping wing tremor negative, bilateral ankle clonus negative, Babinski sign negative. Hepatoconjam continued to be treated for 2 weeks after admission, his condition did not improve, and he was still hot (about 38 ° C). He had severe headache accompanied by nausea and vomiting.