自30年代报道原发性肝癌伴低血糖症以来,国内报告较多,原发性肝癌合并低血糖昏迷者报道较少,本院遇见一例报告如下。患者男性,65岁,住院号867037。半月来因清晨自觉软弱无力,心悸,全身肢体震颤,15分钟后,四肢乱动,视物不清,继之嗜睡,呼之不应而收治入院。患者肝区疼痛半年余,乏力、食纳尚可、未就医。否认肝炎病史,无特殊嗜好。检查;Bp13.3/9.33KPa巩膜无黄染,锁骨上淋巴结不肿大,桶状胸,心肺(一),腹平软,肝助下6cm,剑突下7cm,质硬,表面不光滑,有压痛,脾未扪及,腹水症(一),神经系统检查未见异常。实验室检查:肝功能基本正常,γ-GT 262u,AKP 11.7u/金氏,AFP放免法测定为75μg/L,脑电图正常。B超提示肝右叶血管纹理不清,满布大小不等的强光团,大的约13×10mm,8×12mm,胆囊47×22mm内有大小不等的强光团伴有声影,提示肝癌伴胆石症。核素扫描提示肝右叶占位性病变,入院后第一天清晨发作时抽空腹血糖0.616m mol/L以后每天清晨均有低白糖症状发作,最后神志不清,经静注高渗葡萄糖,2～4小时后转清。以后每天清晨4时给予静注 Since the reporting of primary liver cancer with hypoglycemia in the 1930s, there have been more domestic reports, and there have been relatively few reports of primary liver cancer patients with hypoglycemic coma. This hospital met a case report as follows. Male patient, 65 years old, hospital number 867037. In the first half of the month, she was conscious of weakness and heart palpitations. Her body tremors occurred. After 15 minutes, the limbs tampered with each other and the material was unclear, followed by drowsiness. She was not admitted and admitted to hospital. He suffered liver pain for more than half a year, lack of strength, food and clothing, and no medical treatment. He denied the history of hepatitis and had no special hobby. Examination; Bp13.3/9.33KPa sclera no yellow stain, no enlargement of supraclavicular lymph nodes, barrel chest, heart and lung (a), abdominal soft, liver assisted 6cm, xiphoid 7cm, hard, surface is not smooth, There was tenderness, splenomegaly, ascites (I), and no abnormal neurological examination. Laboratory examination: Liver function was normal, γ-GT 262u, AKP 11.7u/Gold, AFP radioimmunoassay was 75 μg/L, and EEG was normal. B-ultrasound indicates that the blood vessels of the right lobe of the liver are unclear in texture, covered with glare groups of different sizes, and are about 13×10mm, 8×12mm, and gallbladder 47×22mm. Liver cancer with cholelithiasis. Radionuclide scans suggest lesions in the right lobe of the liver. Fasting blood glucose at 0.616 mol/L after the onset of the morning on the first day after admission was followed by hypoglycemic episodes every morning. At last, the consciousness was unclear and hyperosmotic glucose was administered intravenously. After 2 to 4 hours turn clear. After 4 o’clock in the morning every morning to give intravenous injection