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患者男性,58岁,15年前,因低热、咳嗽、咳痰、咯血、确诊为肺结核,间段性不规则治疗十余年,因胸闷、气喘、伴痰血、逐渐加重一个月收入院。体检全身皮肤及粘膜未见出血点,左镇骨上淋巴结可触及数个约2×1cm大小的淋巴结、无触痛。气管右移。右胸塌陷,两肺可闻及广泛性湿罗音、心脏叩、听诊正常,腹软,肝、脾未触及。胸片示:气管右移,右上肺大片状高密度阴影,内有透光区,右中下肺收缩,呈纤维化改变,左肺上、中、下肺野均可见密度不均的片条状阴影;左上肺可见透光区。痰找抗酸杆菌两次阳性,痰结核菌培养阴性。Hb4.0/L
Male, 58 years old, 15 years ago, because of fever, cough, sputum, hemoptysis, diagnosed as tuberculosis, intermittent irregular treatment for more than ten years, due to chest tightness, asthma, with sputum blood, and gradually increase the income of a month hospital. Physical examination of the skin and mucous membrane of the body without bleeding, the left town bone lymph nodes can reach the number of about 2 × 1cm size of the lymph nodes, no tenderness. Right trachea. Right chest collapse, both lungs can be heard and extensive wet rales, heart knock, auscultation normal, abdominal soft, liver, spleen not touched. Chest radiograph showed right trachea and large high-density shadow of the right upper lung. There was translucent area inside, right middle and lower lung constriction, fibrosis, left and right lung field with uneven density Striped shadow; visible left upper lung area. Phlegm looking positive for acid-fast bacilli, sputum TB culture negative. Hb4.0 / L