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患者,男,51岁,农民。1989年11月10日起发热、寒战,体温38.5℃。皮肤巩膜进行性黄染,5天后伴右上腹痛。查体:肝肿大右肋下9 cm,触痛明显,血WBC38×10~9/L,N90%、L10%,TTT、TFT、SGPT均正常。HBsAg(-)。总胆红素102.6μmol/L,Ⅱ 58单位。肝CT和肝B超均显示肝右叶14cm×16cm液性占位病变。4次肝穿刺总计抽出巧克力色脓液1600ml,细菌培养阴性。口服灭滴灵600mg 1日3次,连服42天,继以400mg 1日3次维持25天。用药3天后体温即降至正常,肝痛缓解,1周后黄疸明显减退,肝脏缩小,右肋下4 cm,脓腔减至8.3cm×6.3cm,血WBC9×10~9/L,住院50
Patient, male, 51 years old, farmer. November 10, 1989 fever, chills, body temperature 38.5 ℃. Skin sclera progressive yellow dye, 5 days after the right upper quadrant pain. Examination: hepatomegaly right rib 9 cm, tenderness, blood WBC38 × 10 ~ 9 / L, N90%, L10%, TTT, TFT, SGPT are normal. HBsAg (-). Total bilirubin 102.6μmol / L, Ⅱ 58 units. Liver CT and liver B ultrasound showed the right lobe 14cm × 16cm liquid occupying lesions. 4 times a total of liver puncture pumped chocolate pus 1600ml, bacterial culture negative. Oral metronidazole 600mg 3 times a day, and even served 42 days, followed by 400mg 3 times a day for 25 days. After 3 days of treatment, the body temperature dropped to normal, liver pain relief, jaundice significantly reduced after 1 week, liver shrinkage, the right rib 4 cm, abscess reduced to 8.3cm × 6.3cm, blood WBC9 × 10 ~ 9 / L, hospital 50