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病例摘要 患者男性,60岁,退休工人。1982年6月15日入院。 患者自1982年3月初发现尿色深黄,大便灰白色,伴乏力、食欲差、恶心、呕吐。经某医院检查:肝大,GPT142.6IU/L(正常值<30IU/L),TTT2U,TFT(+),黄疸指数80U。中国医学科学院肿瘤医院肝扫描发现肝右叶占位性病变,又经北京协和医院B型超声波检查,发现胆囊大,诊断为梗阻性黄疸,考虑肿瘤。经保守治疗,1周后黄疸消失,症状好转。5月底再次发现尿深黄,大便灰白,无腹痛,来北京医院就诊。检查:肝大,GPT>240IU/L,胆红素总量94μmoI/L(正常值1.7～17.1μmol/L),其中直接胆红素54.7μmol/L(正常值0～3.4μmol/L)尿胆原(±),碱性磷
Case summary Patient Male, 60 years old, retired worker. Admitted to hospital on June 15, 1982. The patient had experienced a deep yellow urine and gray stools in early March 1982, with fatigue, poor appetite, nausea, and vomiting. After a hospital examination: liver, GPT 142.6IU/L (normal value <30IU/L), TTT2U, TFT (+), jaundice index 80U. The liver scan of the Cancer Hospital of the Chinese Academy of Medical Sciences revealed a lesion in the right lobe of the liver, and was examined by B-mode ultrasonography in the Peking Union Medical College Hospital. It was found that the gallbladder was large and the diagnosis was obstructive jaundice. The tumor was considered. After conservative treatment, the jaundice disappeared after 1 week and the symptoms improved. At the end of May, he discovered urine dark yellow, gray stool, and no abdominal pain. He came to a Beijing hospital for treatment. Examination: Liver, GPT> 240 IU/L, total bilirubin 94 μmo I/L (normal value 1.7 to 17.1 μmol/L), direct bilirubin 54.7 μmol/L (normal value 0 to 3.4 μmol/L), urine Gallbladder (±), basic phosphorus