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患者男性,71岁,于1972年10月24日急症入院。一周前双踝发生肿胀,逐渐延及小腿和大腿,用利尿药治疗无效。2天前感腹胀,伴气急。以往体健,20年来从事于聚合氯乙烯单体的生产工作。体检见明显水肿,中度腹水,肝脏肋下2指,右手杜氏挛缩。全血细胞计数3次,除1次血小板计数为80,000/毫米~3外,其余均正常。肝功能试验示血清胆红素轻度升高(2.7毫克%),血清白蛋白降低(2.1克%),凝血酶原活力为35%,口服植物维生素K后增至65%。同位素扫描示肝脏弥慢性肿大,同位素呈斑点状分布;脾脏亦肿大,其同位素分布密度较肝脏略高。总的情况提示肝有硬化。肝脏活检标本呈碎片状,但结构正常,未见纤维化,
The patient, male, aged 71, was admitted to hospital on October 24, 1972. A week ago, swelling of the ankle, gradually extending to the lower leg and thigh, with diuretic therapy ineffective. Feeling bloating 2 days ago, with acute gas. Past physical health, 20 years engaged in the production of vinyl chloride monomer. Physical examination showed obvious edema, moderate ascites, liver ribs 2 fingers, right hand Duchenne contracture. Whole blood count 3 times, except for a platelet count of 80,000 / mm ~ 3, the rest were normal. Liver function tests showed a slight increase of serum bilirubin (2.7 mg%), a decrease of serum albumin (2.1 g%), a 35% activity of prothrombin, and an increase of 65% after oral administration of vitamin K. Isotope scanning showed chronic diffuse enlargement of the liver, isotopes were spotted distribution; spleen is also swollen, its isotope distribution density slightly higher than the liver. The general situation prompted liver cirrhosis. Liver biopsy specimens were fragmented, but the structure is normal, no fibrosis,