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例1 男患,52岁,低热、腹胀、尿少入院。查体:T37.2℃、Bp11/9kPa。面及胸部散在蜘蛛痣,肝掌。右下肺叩浊,呼吸音消失。腹围87cm,腹壁静脉怒张,肝肋下未及,脾肋下3cm,腹水征阳性。化验:血红蛋白90g/L,白细胞12.5×10~9/L,血沉42mm/h。肝功能异常,血清白蛋白28g/L,球蛋白30g/Lh。腹水为漏出液。胸透,右侧中量积液。食管钡餐有静脉曲张。B超示肝硬化腹水,脾大。输白蛋白、保肝利尿治疗40天,血清白蛋白升至34g/L,腹水完全吸收。患者仍有低热、中量胸腔积液、穿刺化验呈渗出液,加用抗结核药12天后胸水吸收,体温、血沉恢复正常。
Example 1 male suffering from, 52 years old, fever, bloating, oliguria hospitalization. Physical examination: T37.2 ℃, Bp11 / 9kPa. Surface and chest scattered spider nevus, liver palms. Lower right lung tap turbid, breath sounds disappear. Abdominal circumference 87cm, abdominal vein engorgement, hepatic ribs under, spleen ribs 3cm, ascites sign positive. Laboratory tests: hemoglobin 90g / L, white blood cells 12.5 × 10 ~ 9 / L, erythrocyte sedimentation rate 42mm / h. Liver dysfunction, serum albumin 28g / L, globulin 30g / Lh. Ascites is leakage of liquid. Chest throat, the right amount of fluid. Esophageal barium meal varicose veins. B ultrasound showed cirrhosis ascites, splenomegaly. Albumin, liver protection diuretic treatment for 40 days, serum albumin rose to 34g / L, ascites completely absorbed. Patients are still low fever, volume pleural effusion, puncture test showed exudate, plus anti-tuberculosis drugs after 12 days of pleural fluid absorption, body temperature, erythrocyte sedimentation rate returned to normal.