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患者,男,59岁。上腹隐痛,恶心,纳差3月,上腹包块2月。既往有慢性腹胀史20年。体检:恶液质。锁骨上淋巴结不大。心肺(一)。心窝部触及10×7cm大小肿块,质硬,稍压痛,表面结节感,活动度差。肝脾未扪及。胃肠钡餐透视:胃窦癌。纤维胃镜检查:(1)溃疡型胃癌(胃窦部,进展期);(2)胃、十二指肠浅表性炎症;(3)胃内绦虫感染。绦虫头节吸附于胃窦小弯侧,用活检钳未能取出绦虫。实验室检查:Hb 95 g/L,RBC 3.2×10~(12)/L,WBC7.2×10~9/L,N70%,L30%。血型“B”。大便潜血试验(+)。粪镜检查到绦虫卵。用槟榔100g,南瓜子30g,驱绦虫3次,粪检到绦虫成虫。复查大便,虫卵(-)。
Patient, male, 59 years old. Epigastric pain, nausea, anorexia March, upper abdominal mass in February. The past has a history of chronic abdominal distension for 20 years. Physical examination: dysentery. Supraclavicular lymph nodes are not large. Cardiopulmonary (I). The fossa touches a 10×7cm lump, which is hard, slightly tender, with nodular sensation and poor activity. Liver and spleen were not affected. Gastrointestinal barium meal perspective: gastric antrum cancer. Gastric endoscopy: (1) ulcerated gastric cancer (gastric antrum, advanced phase); (2) superficial inflammation of the stomach and duodenum; (3) gastroenteral infection. Aphid head was adsorbed on the small curved side of the antrum, and the aphid could not be removed with a biopsy forceps. Laboratory tests: Hb 95 g/L, RBC 3.2×10 12/L, WBC 7.2×10 9/L, N 70%, L 30%. Blood type “B”. Fecal occult blood test (+). Fecal microscopic examination of Ascaris eggs. With betel nut 100g, pumpkin seeds 30g, drive worms 3 times, feces detected adult worms. Review stools, eggs (-).