![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
昨天早上九点半突发腹部剧烈疼痛。2014年接受肝内胆管结石手术后第一次突发剧痛,检查后发现胆管扩张1.2CM,疑似胆管炎,本地医生给我用了6542、头孢、法莫替丁,请问医生我这个需要怎么用药。6542用后反应比较剧烈,眼睛视物模糊。(女,57岁)
图片因隐私问题无法显示
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
不好意思,今天上班比较忙
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
有饮酒史没有
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
做了什么检查发现胆管扩张?有没有做磁共振?
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
血常规有没有问题?
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
CT检查胆管扩张,血常规正常,没有饮酒使。
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
要做一个上腹磁共振增强+MRCP检查
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
胆管扩张是不是胆管结石引起的
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
654-2不能用的话,可以用其他的解痉药,比如间苯三酚
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
肝内胆管结石是做了ERCP吗?
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
现在腹痛症状好些了吗?
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
现在已经完全不痛了但是昨天做CT没看见石头卡在胆管。只看见胆管扩张。
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
CT看胆管结石不如MRCP准确。MRCP可以把胆管显现出来。
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
肝功能轻度异常,有没有乙肝病史?查了肝炎病毒标记物没有?自身免疫抗体?免疫相关抗体?
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
可以用点保肝的药
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
比如多烯磷脂铣胆碱
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
胆红素正常,目前没有胆汁淤积的证据
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
胆汁酸很高,这个怎么解决?目前我需要用什么药?核磁共振我目前还做不了。
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
没有肝炎
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
熊去氧胆酸
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的。谢谢医生。目前就是吃易善复和熊去氧吗?
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
嗯嗯
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
避免使用肝损害的药物
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
比如感冒药
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的。我这个就是说必须做核磁共振对吗?
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
我有高胰岛素血症,最近还可以用利拉鲁肽吗?或者二甲双瓜
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
我之前怀孕的时候就是孕妇胆汁淤积症
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
这些我之前都查过没问题的。
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的。那我先吃药吧医生。谢谢您!
![](https://resourced.chunyu.mobi/X88AAACnn7iNXn0X-8934a2c6-efd2-4f75-92fe-975482b2275b_w492_h507_.png?imageMogr2/thumbnail/150x)
黄更珍医生
不客气
提示:疾病因人而异,他人的咨询记录仅供参考,擅自治疗存在风险。
咨询时间: 2023-10-02