论文部分内容阅读
病例报告王××,女性,21岁,于1963年2月11日因咳嗽、声嘶、发烧已三个月而入院.患者于1962年11月受凉后即发生咳嗽、发烧、胸痛、喉部不适,以后声音渐渐嘶哑,疲乏无力,夜间盗汗,但不咳血痰,曾经中西医治疗无效.以后病情加剧,痰渐变浓,日渐消瘦,体重锐减.既往身体一向健康,无慢性咳嗽咳血史. 体检:营养欠佳,慢性重病容,消瘦,说话声嘶.心未发现异常.右肺呼吸音粗,左肺有多量湿性啰音.腹软无压痛,肝脾未触及. 实验室检查:血红蛋白49%,红细胞290万,白细胞11,000万,中性79%,淋巴21%.血沉104毫米/小时.大小便正常.痰:两次涂片找到抗酸杆菌,培养有霉菌生长.胸透:两肺区均有散布性大量的斑片状影,心膈受侵及显边缘不清. 入院诊断:①浸润性肺结核,浸润进展期丙(上中下)/(上中下)(+);②喉结核. 治疗经过:入院后即按抗结核治疗(异烟肼、链霉素),并用大量青霉素及维生素,后又加用红霉素,症状未好转,且继续恶化.2月14日胸透发现左胸有少量液气胸,26日乃行胸腔穿刺,于左腋
Case Report Wang XX, female, 21 years old, admitted to hospital for coughing, hoarseness, and fever for three months on February 11, 1963. The patient developed cough, fever, chest pain and throat in the cold of November 1962 Discomfort, after the voice gradually hoarse, tired and weak, night sweats, but not bloody bloody sputum, had Chinese and Western medicine treatment ineffective. Later aggravate the condition, sputum gradual thickening, weight loss, weight plummeted. Past body has always been healthy, no chronic cough and hemoptysis history Physical examination: poor nutrition, chronic severe illness, weight loss, voice hoarseness. Heart not found abnormalities. Right lung breath sounds rough, the left lung has a lot of wet rales. Abdominal soft no tenderness, liver and spleen not touched. Laboratory tests: Hemoglobin 49%, erythrocyte 2.9 million, white blood cells 110 million, 79% neutral, lymphatic 21% erythrocyte sedimentation rate 104 mm / hour normal urine sputum: two smears to find acid-fast bacilli, Inflammatory pulmonary tuberculosis, infiltration of advanced C (upper middle and lower) / (upper and lower) (+), ; ② laryngeal tuberculosis. After treatment: by anti-tuberculosis treatment after admission (isoniazid, streptomycin), and with a large number of penicillin and maintenance , Then added with erythromycin, the symptoms are not improved, and continues to deteriorate. February 14 chest X-ray found a small amount of liquid left chest pneumothorax, 26, is the thoracentesis, in Zuoye