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患者,男性,66岁,住院号17467。因上腹痛伴呕吐咖啡色胃内容物2小时,于1994年3月25日17:30急诊入院。既往有冠心病史,有原发性肝癌手术切除史(1992年6月)。入院体检:体温36℃,血压15/10kPa,神清。两肺呼吸音清晰;心界不大,心率76次/分,心律齐,各瓣膜区未闻杂音。右上腹见手术疤痕。肝脾未触及。神经系统无特殊发现。心电图STⅡ、Ⅲ、aVF呈缺血型压低。B超:肝脏回声粗糙。提示肝硬化。血常规:血红蛋白100g/L,白细胞7.0×10~9/L,血小板186×10~9/L。尿常规正常。大便潜血++。肝、肾功能正常。AFP阴性。诊断:①上消化道出血:食道—胃底静脉曲张破裂;②肝癌切除术后;③冠心病。入院后予禁食、止血、降门脉压等综合治疗,出血停止。住院第三天,进食少许热牛奶后,患者突然大量
Patient, male, 66 years old, hospital number 17467. Due to abdominal pain with vomiting brown stomach contents 2 hours, at 17:30 on March 25, 1994 emergency admission. Past history of coronary heart disease, history of surgical resection of primary liver cancer (June 1992). Admission medical examination: body temperature 36 ℃, blood pressure 15 / 10kPa, Shen Qing. Breath sounds clear two lungs; heart is not heart rate 76 beats / min, heart rate Qi, the valve area did not smell noise. Right upper quadrant surgery scar. Liver and spleen not touched. Nervous system no special findings. ECG ST Ⅱ, Ⅲ, aVF showed ischemic depression. B ultrasound: rough liver echo. Prompted cirrhosis. Blood: hemoglobin 100g / L, white blood cells 7.0 × 10 ~ 9 / L, platelets 186 × 10 ~ 9 / L. Urine routine normal. Fecal occult blood ++. Liver, kidney function is normal. AFP negative. Diagnosis: ① upper gastrointestinal bleeding: esophageal - gastric varices; ② liver resection; ③ coronary heart disease. After admission to fasting, bleeding, lowering portal pressure and other comprehensive treatment, bleeding stopped. The third day of hospitalization, after eating a little hot milk, a sudden a large number of patients