论文部分内容阅读
病例报告例1 男,69岁.进行性皮肤巩膜黄染1 mo,伴纳差、乏力、消瘦入院.查体:皮肤巩膜明显黄染,心肺正常,腹平软无压痛,肝脾肋下未及,移动性浊音阴性.血 WBC 6.2×10~9/L,N0.61,BUN 7.9 mmol/L,Cr 167 μmol/L,TBll 340 μmol/L,DBIl 220 μmol/L,ALT 正常,血钾5.47 mmol/L.B超、CT 提示肝内胆管重度扩张、肝门部胆管癌.入院后2 d 行 ERCP 术,注射300 g/L 泛影葡胺40 mL,见左右肝管及分支细线样狭窄,长约3 cm,左侧为重,左右肝管汇合部充盈欠佳,肝内胆管重度扩张,诊断肝门部胆管癌(Bismuth Ⅳ),行乳头小切开,留置7F 单
Case report, male, 69 years old, progressive scleral yellow dye 1 mo, with anorexia, fatigue, weight loss admitted to hospital Physical examination: the sclera of the skin was obviously yellow, normal heart and lung, abdominal tenderness and tenderness, (P <0.01), and the voiced negative of mobility was negative.WBC was 6.2 × 10 ~ 9 / L, N0.61, BUN 7.9 mmol / L, Cr 167 μmol / L, TBll 340 μmol / L, DBI1 220 μmol / 5.47 mmol / LB, CT showed severe intrahepatic bile duct expansion, hilar cholangiocarcinoma ERCP surgery 2 d after admission, injection of 300 g / L diatrizoate 40 mL, see the left and right hepatic duct and branches fine line-like stenosis , About 3 cm in length, left to the weight of the left and right hepatic duct confluence filled poorly, intrahepatic bile duct severe dilatation, diagnosis of hilar cholangiocarcinoma (Bismuth Ⅳ), small incision nipple, leaving a single 7F