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例1,男,15岁。因右侧胸部隐痛不适伴潮热、盗汗2个月于1997年9月22日入院。入院检查:T37.5℃,右侧胸腔积液征(+)。胸片示:气管左移,右肺中下野大片均匀致密,达第二前肋水平,呈外高内低弧形影。B超探查示:右侧胸腔大量积液。PPD:强阳性。血沉:46mm/h。胸水检查示:草黄色渗出液。经皮胸膜活检病理学报告:结核性胸膜炎。诊断:右侧结核性渗出性胸膜炎。予2HRZ/4HR方案化疗。强的松20mg口服,1次/d。同时胸穿抽液1～2次/周,800～1000ml/次,2周后症状明显改善,胸片示少量右侧胸腔积液。第3周,病人突感腹痛、腹胀,伴畏寒、发热。体检:T39℃,腹稍隆,全腹轻压痛,移动性浊音(+)。B超示:大量腹水。腹穿抽液检查示;草黄色渗
Example 1, male, 15 years old. Because of the right chest pain and discomfort with hot flashes, night sweats 2 months on September 22, 1997 admission. Admission examination: T37.5 ℃, right pleural effusion sign (+). Chest X-ray showed: left trachea, right middle and lower lung large area evenly dense, up to the level of the second anterior rib was high inside and outside the arc-shaped shadow. B ultrasound probe shows: a large pleural effusion on the right side. PPD: Strongly positive. ESR: 46mm / h. Examination of pleural fluid showed: grass yellow exudate. Percutaneous pleural biopsy pathology report: tuberculous pleurisy. Diagnosis: Right tuberculous exudative pleurisy. To 2HRZ / 4HR regimen chemotherapy. Prednisone 20mg orally, 1 time / d. At the same time chest wear fluid 1 ~ 2 times / week, 800 ~ 1000ml / time, 2 weeks after the symptoms improved significantly, chest X-ray showed a small amount of right pleural effusion. Week 3, the patient suddenly felt abdominal pain, bloating, with chills, fever. Physical examination: T39 ℃, abdomen slightly bulging, all tender abdominal tenderness, shifting dullness (+). B show: a lot of ascites. Abdominal wear pumping test showed; grass yellow seepage