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患者 男,46岁,乏力、纳减伴全身黄染反复1月余,加重10天入院。 体检:体温37.2℃,慢性病容,皮膜巩膜深度黄染,全身浅表淋巴结未扪及肿大,胸前未见蜘蛛痣,腹胀,上腹部隆起,可扪及肿块,肿块下界边缘达脐部,质硬,表面光滑,叩痛,腹水征(+)。 实验室检查:AFP 7345ug/ml,肝功能未见异常。 B超:肝上界第6肋间,右肋下1cm肝表成平,肝内回声增粗、增强,分布久均,血管显示尚清,门静脉不扩张,胆囊5.5×2cm轮廓欠清,壁毛糙,胆汁透声极
The patient was a 46-year-old man. He suffered fatigue, was relieved of having systemic jaundice for more than one month, and he was admitted for more than 10 days. Physical examination: body temperature 37.2°C, chronic disease, deep yellow stain on the epithelium, superficial superficial lymph node enlargement, enlargement, no spider axillae on the chest, abdominal distention, upper abdomen uplift, palpable mass, lower boundary of the mass reaching the umbilicus, Hard, smooth surface, pain, ascites sign (+). Laboratory examination: AFP 7345ug/ml, no abnormal liver function. B-mode ultrasound: the 6th intercostal space of the upper liver, 1cm of the right subcostal surface is flat, the intrahepatic echo is thickened, enhanced, and the distribution is long, the blood vessels are still clear, the portal vein is not expanded, the contour of the gallbladder is 5.5×2cm, and the wall is rough Bile