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患者男,21岁。因反复乏力、恶心、纳差、腹胀、尿黄22年,加重伴少尿半月。于1991年拟诊“肝炎后肝硬化失代偿”第2次入院治疗。查体:一般情况较差,神志清楚,反应迟钝,说话不清,智力较正常同龄人差,表情淡漠,似有假面具面容,步态蹒跚。双上肢细颤,以左上肢明显,皮肤黝黑,皮肤、巩膜轻度黄染,肝掌可疑,两乳房乳晕着色,肿大约4cm×4cm,表浅活动,双下肢凹陷性水肿。咽后壁轻度充血,扁档体Ⅰ°肿大。双肺(—),心音低钝。腹部膨隆,腹壁静脉充盈,腹部轻度压痛,肝上界右锁骨中线5肋间,肋下未触及,剑下2cm,质地中等,有结
Patient male, 21 years old. Due to repeated fatigue, nausea, anorexia, abdominal distension, urinary yellow 22 years, aggravated with oliguria half. In 1991 to be diagnosed “hepatitis cirrhosis decompensation,” the second admission treatment. Physical examination: the general situation is poor, conscious, unresponsive, unclear, intelligence worse than normal peers, expression indifference, it seems that there are false masks, gait hobbled. Both upper extremities tremors to the left upper extremity was obvious, dark skin, scleral mild yellow dye, liver palms suspicious, two breast areola stained, swollen about 4cm × 4cm, superficial activity, lower limb pitting edema. Posterior pharyngeal mild hyperemia, flat body Ⅰ ° swollen. Two lungs (-), low heart sound blunt. Abdominal bulging, filling the abdominal veins, mild abdominal tenderness, the upper right hepatic supraclavicular midline 5 intercostal, ribs did not touch the sword 2cm, medium texture, knot