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患者男,42岁。因昏迷6小时,伴左侧肢体抽搐入院。患者早晨起床时发现意识不清,伴左侧肢体抽动。平素健康。查体:意识不清,周身浅表淋巴结无肿大,右侧瞳孔约2mm,左侧瞳孔约3.5mm,颈部稍抵抗。左侧肢体肌张力增强,并有阵发性抽动,右侧肢体肌力正常,双侧巴氏征阴性,X线胸片未见异常改变。肝脏B超:肝右叶有4cm×5cm光团,光点强弱不均,边缘不整与周围肝组织界限不清楚。腹部CT:肝脏右叶有4cm×5cm密度减低区,提示占位病变。病变部位针刺活检,发现肝瘤细胞。肝功能:A/G比值正常。γ-谷氨酰转肽酶198u;碱性磷酸酶80u(金氏)。甲胎球蛋白定性阳性,定量>2000ng/L。血糖1.1mmol/L。诊断原发性肝癌,昏迷原因为低血糖。给患者
Male patient, 42 years old. Due to a coma for 6 hours, with left limb convulsions admitted. Patients get up in the morning to find unconscious, with the left limb twitching. Usually healthy. Examination: Consciousness, whole body superficial lymph nodes without swelling, the right pupil about 2mm, left pupil about 3.5mm, the neck a little resistance. Left limb muscle tone enhancement, and paroxysmal twitch, right limb muscle strength, bilateral Pakistan’s sign negative, X-ray showed no abnormal changes. Liver B ultrasound: the right lobe of the liver 4cm × 5cm light group, uneven light intensity, the edge is not clear and the surrounding liver tissue is not clear. Abdomen CT: Right lobe of the liver has a 4 cm x 5 cm densitometer area, suggesting a mass space lesion. Lesions acupuncture needle biopsy and found that liver tumor cells. Liver function: A / G ratio normal. γ-glutamyl transpeptidase 198u; alkaline phosphatase 80u (Kim). A fetuin qualitative qualitative, quantitative> 2000ng / L. Blood sugar 1.1mmol / L. Diagnosis of primary liver cancer, coma causes hypoglycemia. To the patient