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经皮超声介入肝癌内注射无水酒精(PEIT)术后并发右悸肋区痛、发热等现象较常见,且作一般处置后即可缓解。对于术后并发严重的消化道应激性溃疡出血尚未见报告,本文报告1例。 患者男,40岁。腹胀伴有右上腹不适、痛疼半月,无呕吐、呕血史,否认肝病、胃病史。查体:心肺无异常发现。腹隆起、肝区叩击痛,肋下可触及中等硬度之肝脏,脾未触及,肠鸣音弱。锁骨上无肿大淋巴结。B超检查提示:腹内有大量腹水,肝右叶探及75×10cm的强回声絮状斑块,边界不清,脾正常大。上消化道造影食管无静脉曲张,胃及12指肠未见异常。化验:WBC3900,Hb13g、血小板12.5万,肝功能、血生化正常,HBsAg(阴性)、AFP980ng/ml,γ-GT<50u,腹水及肝穿刺吸出物细胞学检查见癌细胞。临床诊断原发性肝癌。
Percutaneous ultrasound intervention in intrahepatic injection of anhydrous alcohol (PEIT) after the right temporal rib area complicated by pain, fever and other phenomena are common, and can be relieved after general treatment. Severe postoperative complications of gastrointestinal stress ulcer bleeding have not been reported. One case was reported in this paper. Male patient, 40 years old. Abdominal distension was associated with right upper quadrant discomfort, pain and pain for half a month, no vomiting, history of vomiting, and denial of liver and stomach history. Physical examination: No abnormalities found in heart and lung. Abdominal uplift, hepatic percussion pain, ribs can touch the moderate hardness of the liver, the spleen does not touch, bowel sounds weak. There are no enlarged lymph nodes on the clavicle. The B-ultrasonic examination suggested that there was a large amount of ascites in the abdomen, the right lobe of the liver and a strong echo flocculent plaque of 75×10 cm. The boundary was unclear and the spleen was normal. No varicose veins were found in the upper gastrointestinal contrast esophagus, and no abnormalities were observed in the stomach and the 12th intestine. Laboratory tests: WBC3900, Hb13g, platelets 125,000, liver function, normal blood biochemistry, HBsAg (negative), AFP980ng/ml, γ-GT <50u, ascites and liver puncture aspirate cytology see cancer cells. Clinical diagnosis of primary liver cancer.