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患者男,56岁,因“反复乏力纳差5年,加重1个月”于2004年2月2日入院。有肝炎史5年,明确诊断“肝硬化”1个月余。入院查体:皮肤巩膜深黄,蜘蛛痣阳性,气急,紫绀较明显,双肺呼吸音粗,未闻及干湿罗音,腹软无压痛,肝肋下来及,剑突下2cm,质韧,脾肋下2cm,腹水征阳性,NS无异常。肝功能:ALT213U/L,AST357U/L,TBiL214.3μN,A/G0.95。入院诊断:慢性重症肝炎,肝炎后肝硬化腹水。入院后查:胸片:双肺无实变影。B超:肝硬化腹水,脾肿大。血常规:WBC6.8×109/L,N0799。血气分析(2月3日):见表1。符合Ⅰ型呼衰,呼吸性碱中毒。考虑肝-肺综合征,给予:善得定0.3mg/d,大蒜素针90mg/d。同时给予血浆支持,甘利
Male patient, 56 years old, was admitted to hospital on February 2, 2004 because of “repeated and weak anorexia for 5 years and heavier one month.” A history of hepatitis 5 years, a clear diagnosis of “cirrhosis” more than 1 month. Admission examination: skin sclera dark yellow, spider nevus positive, shortness of breath, cyanosis more obvious, lung breath sounds coarse, unheard and dry and wet rales, abdominal soft and tenderness, liver ribs down and, xiphoid 2cm, tough , Spleen ribs 2cm, positive signs of ascites, NS no abnormalities. Liver function: ALT213U / L, AST357U / L, TBiL214.3μN, A / G0.95. Admission diagnosis: Chronic severe hepatitis, posthepatitic cirrhosis ascites. After admission check: chest radiograph: no change in both lungs. B ultrasound: cirrhosis, splenomegaly. Blood: WBC6.8 × 109 / L, N0799. Blood gas analysis (February 3): See Table 1. Meet Ⅰ type respiratory failure, respiratory alkalosis. Consider liver-lung syndrome, given: good to be given 0.3mg / d, allicin 90mg / d. At the same time give plasma support, Ganli