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患者,男,84岁,农民。1998年8月4日就诊。呃逆1周,在本院门诊先后给予镇静、解痉,“氯丙嗪”、“安定”、“654-2”、“尼莫地平”、“硝苯地平”等药物治疗,呃逆仍不能终止。追问病史,患者不咳嗽,无胸痛,无心悸心慌,无畏寒发热,无腹痛、腹胀,饮食略有减少。检查:心肺无异常发现,腹平坦,全腹无触痛,剑突下仅有压之不适,无压痛,墨菲征(-)。为进一步排除膈上、膈下病变,行胸透:心肺正常,肋膈角正常。B超:肝未见占位,胆囊壁水肿,胆囊见数个强回声光团伴声影。血象:Hb 120g/L,RBC 3.30×10~(12)/L,WBC 13×10~9/L,N 0.81,L 0.19。考虑呃逆与胆囊炎有关。即给抗生素加激素静脉给药治疗,当
Patient, male, 84 years old, farmer. August 4, 1998 for treatment. Hiccups 1 week, in our hospital has given to sedation, antispasmodic, “chlorpromazine”, “stability”, “654-2”, “nimodipine”, “nifedipine” and other medical treatment, hiccups still can not be terminated . Asked history, the patient does not cough, no chest pain, no palpitations palpitation, no chills fever, no abdominal pain, bloating, a slight decrease in diet. Check: no abnormal heart and lung findings, flat belly, full abdomen without tenderness, pressure only under the xiphoid discomfort, no tenderness, Murphy sign (-). To further rule the diaphragm, diaphragm disease, line chest: normal heart and lung, costophrenic angle normal. B-super: liver no placeholder, gallbladder wall edema, gallbladder see several strong echo light group with sound shadow. Blood: Hb 120g / L, RBC 3.30 × 10-12 / L, WBC 13 × 10-9 / L, N 0.81, L 0.19. Consider hiccups associated with cholecystitis. That antibiotics and hormones intravenous treatment, when