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患者,女,41岁,农民,住院号:190982。13年前,产后身体逐渐肥胖,近3年体重明显增加,伴头昏、头痛、心慌、气短、易疲乏,受凉后上述症状加重。睡眠时鼾声大作,常因呼吸困难而惊醒,白天嗜睡。3天前因受凉后咳嗽,气短,夜间不能平卧,下肢浮肿,尿量减少而入院。查体:明显肥胖,体重95kg,口唇紫绀,两颊紫红色,神志清,迫坐,血压160/110m-mHg,全身皮肤未见痤疮、紫纹,颈静脉稍怒张,两肺呼吸音低,两肺底可闻小湿鸣,心脏向左略大,心率110次/分,律齐,P_2>A_2。腹软,肝触诊不满意,腹水征(-)下肢呈明显可凹性浮肿。神经系统无异常。实验室检查:
The patient, female, 41 years old, farmer, hospital number: 190982. 13 years ago, the body after birth gradually obesity, body weight increased significantly over the past 3 years, with dizziness, headache, palpitation, shortness of breath, fatigue, increased symptoms after the cold. Sleep snoring masterpiece, often awakened by difficulty breathing, daytime sleepiness. 3 days ago due to cold cough, shortness of breath, night can not lie down, lower extremity edema, decreased urine output and admission. Examination: Obesity, weight 95kg, cyanotic lips, purple cheeks, conscious, forced sitting, blood pressure 160 / 110m-mHg, no skin acne, purple pattern, jaundice a little jugular vein, lungs breath sounds low , Two lungs can be heard small wet mute, slightly left heart, heart rate 110 beats / min, law Qi, P_2> A_2. Abdominal soft, liver palpation is not satisfied, signs of ascites (-) lower limb was significantly concave edema. Nervous system no abnormalities. Laboratory examination: