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患者男,47岁。因反复咳嗽、咯血、咯血痰、气促2年半,加重1月第2次入院。患者2年半前咳嗽、吐绿色粘痰,痰中带血,气促,胸片示支气管疾患,诊断支气管扩张并感染、咯血住院,经静滴青霉素800万u/日,庆大霉素16万u/日,症状缓解出院,但每遇受凉、劳累后易复发。一月来夜间阵性刺激性剧咳,声嘶,吐绿痰,似豆腐状,间歇性咯血,气促。无结核史,有吸烟史。体查:体温38℃,血压14.6/9.3kPa。口唇轻度紫绀。胸郭略呈桶状,右中、下肺叩诊稍浊,呼吸音明显减低,可闻及细湿性罗音,全肺清晰。心率84次,律齐。有杵状指。尿常规、血肌酐、肝功能均正常,血红蛋白95g/L,白细胞14×10_9/L,中性79％,淋巴21％;6次痰查抗酸
Male patient, 47 years old. Due to repeated coughing, hemoptysis, hemoptysis sputum, shortness of breath 2 and a half years, increased in January 2nd admission. Two and a half years before the patient cough, spit green phlegm, sputum bloody, shortness of breath, chest X-ray showed bronchial disease, bronchiectasis and infection diagnosis, hemoptysis hospitalized by intravenous penicillin 8 million u / day, gentamicin 16 Wan u / day, relieve symptoms discharged, but each case of cold, tired and easy to relapse. In January, the evening irritation of dramatic irritable cough, hoarseness, spit green sputum, like bean curd, intermittent hemoptysis, shortness of breath. No TB history, history of smoking. Physical examination: body temperature 38 ℃, blood pressure 14.6 / 9.3kPa. Mild cyanosis lips. Chest Guo slightly barrel-like, right middle and lower lung percussion slightly turbid, breath sounds significantly reduced, can be heard and fine wet rales, clear lungs. Heart rate 84 times, law Qi. Clubbing means. Urine routine, serum creatinine, liver function were normal, hemoglobin 95g / L, white blood cells 14 × 10_9 / L, 79% neutral, lymphatic 21%; 6 sputum check acid