贾建伟教授治疗淋巴瘤化疗致肝衰竭验案一则
Liver Failure Caused By Lymphoma Treated by Jia Jianwei:A Case Report
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1.南开大学附属天津市第二人民医院中医科,天津 300192
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雷金艳,贾建伟.贾建伟教授治疗淋巴瘤化疗致肝衰竭验案一则[DB/OL].(2023-11-13)[2023-11-13].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43867601&Fpath=home&index=0&lang=zh
LEI Jinyan,JIA Jianwei.Liver Failure Caused By Lymphoma Treated by Jia Jianwei:A Case Report[J].,
雷金艳,贾建伟.贾建伟教授治疗淋巴瘤化疗致肝衰竭验案一则[DB/OL].(2023-11-13)[2023-11-13].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43867601&Fpath=home&index=0&lang=zh DOI:
LEI Jinyan,JIA Jianwei.Liver Failure Caused By Lymphoma Treated by Jia Jianwei:A Case Report[J]., DOI:.
病史摘要,2,患者高某某,男性,59岁,以“纳差、尿黄1月余”为主诉于2022年12月20日入院。1月余前患者因“巨脾、全血细胞低下”,计划行脾切除治疗术前检查发现淋巴瘤,后行抗肿瘤治疗出现周身乏力、纳差、尿黄,危重时出现高热、神志不清,随即转入ICU抢救,后脱离生命危险,但患者临床症状持续存在,肝功能恢复不顺利,总胆红素持续波动在150 μmol/L左右、PT波动在18 s左右。患者极度痛苦,寻求中医药治疗。四诊信息:精神差,乏力、纳差、身黄、目黄、尿黄,夜眠欠佳,便溏。舌淡红,苔白厚腻,脉弦滑。中医诊断 黄疸(寒湿困脾、气血亏虚证)。西医诊断 1.慢加急性肝衰竭C型,早期;2.乙型肝炎肝硬化失代偿期;3.淋巴瘤;4.脾功能亢进;5.巨脾;6.肝囊肿;7.肺气肿;8.胆囊切除术后;9.肠梗阻术后。干预措施 中医以温阳健脾、利湿退黄、补益气血为法,予茵陈术附汤合保和丸加减治疗;西医予恩替卡韦抗病毒、甘草酸二胺肠溶胶囊及熊去氧胆酸胶囊等保肝、退黄治疗。疗效转归 患者顺利完成脾切除,肝功能、全血细胞均平稳,生活质量满意。
Summary of case history, The patient GaoMoumou, male, 59 years old; was admitted to hospital on December 20, 2022 with the main complaint of "poor appetite and yellow urine for more than 1 month". More than 1 month ago, due to "giant spleen and low total blood cells", the patient was scheduled to undergo splenectomy and lymphoma was found in the preoperative examination. After anti-tumor treatment, the patient showed general weakness, poor appetite, yellow urine, high fever and confusion in critical condition, and was immediately transferred to the ICU for rescue. After that, the patient was out of life danger, but the clinical symptoms persisted, the recovery of liver function was not smooth, and the patient was in extreme pain. Seek Chinese medicine treatment. Four diagnostic information: poor spirit, self-fatigue, poor appetite, yellow urine, poor sleep at night, loose stool. The tongue is pale red, the fur is white and thick, and the pulse string is smooth.,TCM diagnosis, Jaundicedamp-syndrome of cold dampness trapping spleen and deficiency of Qi and blood.,Western medicine diagnosis, 1.Chronic and subacute liverfailure -Hepatitis B cirrhosis; 2. Lymphoma; 3. Hypersplenism.,Therapeutis methods, After admission, In traditional Chinese medicine, the methods of warming Yang and strengthening spleen, removing dampness and withdrawing yellow, supplementing Qi and blood were used to treat Yin Chen Shu Fu Tang and four Junzi. Western medicine gives Entecavir antiviral, glycyrrhizinate enteric-coated capsules and ursodeoxycholic acid capsules for liver protection and yellow treatment.,Clinical outcomes, The patient successfully completed splenectomy, liver function and whole blood cells were stable, and the quality of life was satisfactory.
肝衰竭淋巴瘤医案
Liver failureLymphomaMedical recordsJia Jianwei
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