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男性,55岁,有乙肝病史17年,近2年来间断出现腹胀、乏力,渐消瘦。10天周前进食不洁饮食后出现腹泻、腹痛,服药后腹泻好转,但近3天出现发热,明显腹痛、腹胀,尿量减少。入院后查体:意识尚清,但烦躁多语,巩膜轻度黄染,明显肝掌,可见蜘蛛痣,心肺未见异常;腹部膨隆,脐下腹有压痛,轻度反跳痛,腹水征阳性。急诊化验:血常规:WBC9.2×10
9
/L,中性87%;电解质K
+
3.4mmol/L,Na
+
137mmol/L,Cl
-
97mmol/L,血氨为93μmol/L。该患者基础病的诊断首先应考虑()
A . A.自发性腹膜炎
B . 感染性腹泻
C . 慢性乙型病毒性肝炎
D . 肝炎肝硬化
E . 阑尾炎
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