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患者 男,34岁,四川籍民工。右上腹疼痛2个月,伴意识不清4小时入院。1个月前曾腹部B超检查示:肝内多发大结节性占位性病变,肝硬变,脾大。查体:T36℃,BP14/10kPa(105/75mmHg),消瘦,呈浅昏迷。巩膜、皮肤黄染。心肺无异常。胸腹壁静脉曲张,腹软,肝于右肋缘下4.0cm,质硬,表面凹凸不平,脾脏轻度肿大,腹水征阴性。双下肢巴彬斯基征阳性。诊断为:原发性肝癌并肝昏迷。给于葡萄糖液和胞二磷胆碱静脉滴注,约10分钟后意识清醒,言语清晰,述右上腹疼痛、腹胀。饮食正常。于第2日晨再次昏迷,按前方法治疗10
Patients Male, 34 years old, Sichuan migrant workers. Right upper quadrant pain for 2 months, with unconsciousness 4 hours admission. 1 month ago had abdominal B-ultrasound showed: multiple large nodular space-occupying lesions in the liver, cirrhosis, splenomegaly. Physical examination: T36°C, BP14/10kPa (105/75mmHg), weight loss, light coma. Sclera, yellow skin. No abnormalities in heart and lungs. The chest and abdominal wall veins were varicose and abdomen was soft. The liver was 4.0 cm below the right costal margin. Hard, uneven surface, slightly enlarged spleen, and negative ascites sign. Babinski’s sign was positive in both lower limbs. The diagnosis was: primary liver cancer and hepatic coma. Give glucose fluid and citicoline IV infusion, about 10 minutes after the consciousness sober, clear speech, the right upper abdominal pain, abdominal distension. The diet is normal. On the morning of the second day, I was comaed again and treated according to the previous method 10