论文部分内容阅读
病例摘要苏某,男姓,49岁,农民。因畏寒、发热、消瘦5个月于1986年8月13日入院。入院前4个月起反复发生鼻衄,每次量约100ml,曾拟为肝硬化(失代偿期)和肺结核,并经抗痨(异菸肼、利福平和链霉素和止血治疗。然仍有间断高热,大汉,消瘦明显,胃纳减少,下肢浮肿。既往吸烟已20年,偶而饮酒3年。病前否认服用氯霉素或接触射线,否认有血吸虫病疫水接触史。体检:消瘦,中度贫血貌。皮肤无出血点,无黄染。右颈部、腋下及腹股沟扪到数个黄豆大小的淋巴结。胸骨无压痛,心肺(-),肝肋下2cm,质韧,边锐,无压痛及叩击痛,表面光滑;脾肋下4cm,硬。腹水征(-),神经系(-)。实验室检查:Hb 65g/L,WBC 2.2×10~9/L,P133×10~9/L,大便隐血(+++),血沉40mm/h,总
Case summary Sumou, male surname, 49 years old, farmer. Due to chills, fever, weight loss 5 months on August 13, 1986 admitted. Epistaxis occurs repeatedly four months before admission, about 100 ml each time. It has been proposed for liver cirrhosis (decompensated) and tuberculosis and is treated with anti-tuberculosis (isoniazid, rifampin, streptomycin and hemostasis. However, there is still intermittent fever, Han, weight loss significantly reduced appetite, lower extremity edema .Previous smoking has been 20 years, occasionally drinking for 3 years.Confirmed before taking chloramphenicol or exposure to radiation, denied the history of schistosomiasis exposure to water.Physiological examination: Weight loss, moderate anemia, skin no bleeding point, no yellow dye .Right neck, underarms and groin palpable several soybean size lymph nodes .Sternal no tenderness, cardiopulmonary (-), liver ribs 2cm, quality and toughness, The results of laboratory tests were as follows: Hb 65g / L, WBC 2.2 × 10-9 / L, P133 × 10 ~ 9 / L, fecal occult blood (+++), ESR 40mm / h, total