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1病例介绍患者男,51岁。因“全身多处进行性疼痛6+个月,加重10+d”于2012年7月27日入院。6个余月来,患者腰背部、双下肢远端进行性疼痛加重,疼痛为持续性针刺样感,难以忍受,夜间无法入睡,行动困难。入院前服用双氯芬酸钠止痛,效果尚可。近10+d,患者因受凉后咳嗽加重疼痛,偶伴双上肢麻木至当地医院就诊,院外骨扫描显像示:“全身多处骨质代谢异常,肿瘤骨转移不除外”。为进一步明确诊断入我院。患者8余年前诊断为慢性乙型肝炎,服用拉米夫定2年后出现耐药,后改用阿德福韦酯10 mg/d至今。否认高血压、糖尿病、
1 case description Patient male, 51 years old. Due to “multiple systemic pain for 6 months, increased 10 + d ” on July 27, 2012 admission. More than 6 months, patients with lower back and lower extremity progressive pain worse, persistent acupuncture pain, unbearable, unable to sleep at night, difficult to move. Take diclofenac sodium before admission to relieve pain, the effect is acceptable. Nearly 10 + d, patients with cough due to increased pain after the cold, even with upper extremity numbness to the local hospital, extracranial bone scan imaging showed: “multiple systemic bone metabolism, tumor metastasis is not excluded.” In order to further confirm the diagnosis into our hospital. 8 years ago, patients diagnosed as chronic hepatitis B, taking lamivudine resistance after 2 years, then switch to adefovir dipivoxil 10 mg / d so far. Denied high blood pressure, diabetes,