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患者男,28岁。自幼反复出现呼吸道感染,咳黄痰,鼻堵,流黄涕。1978年确诊为“鼻息肉,鼻窦炎”,药物治疗无效。1980年和1982年曾二次行双侧鼻息肉摘除术。近10年间断咳血、量渐增多。门诊以“鼻中隔偏曲”“慢性化脓性鼻窦炎”于1991年2月5日收入院。查体:身高1.68m,体重60kg。心尖搏动和心浊音区位于右侧,肝浊音区位于左侧。双肺呼吸音减低,左下肺有痰鸣音,轻度杵状指及甲床紫钳。双侧鼻粘膜暗红色,双下甲肿大,麻黄素收缩敏感。双中甲残体,鼻腔未见息肉,双中鼻道及左下鼻道有脓,中隔高位左曲,右前下嵴。鼻窦X线片示双侧额窦发育好。双侧上颌窦、筛窦密度增高。B超:肝胆脾胰全部转位。肺功能检查:小气道阻塞,弥散功能正常。胸部X线片及心电图除右位心外其他均正常。纤维支气管镜:双侧支气管粘膜充血、肿胀、光滑,双支气管入口处有白色
Male patient, 28 years old. Occurred since childhood, respiratory infections, cough yellow sputum, nasal congestion, runny nose. In 1978 was diagnosed as “nasal polyps, sinusitis,” drug treatment is invalid. 1980 and 1982 have twice underwent bilateral nasal polyps removal. Nearly 10 years of broken hemoptysis, the amount gradually increased. Outpatient “nasal septum deviation” “chronic suppurative sinusitis” in February 5, 1991 income hospital. Physical examination: height 1.68m, weight 60kg. Apical beating and dullness zone is located on the right side and dullness zone is located on the left side. Reduced lung breath sounds, sputum ringing the lower left lung sound, mild clubbing and nail bed refers to the clamp. Bilateral nasal dark red, double under the swollen, ephedrine sensitive. Double a residual, no polyps nasal, double nasal and lower left nasal passages pus, left high in the septum, right anterior lower crest. Sinus X-ray showed bilateral frontal sinus development well. Bilateral maxillary sinus, ethmoid sinus increased density. B super: liver, spleen and pancreas translocation. Pulmonary function tests: small airway obstruction, diffuse function is normal. Chest X-ray and ECG in addition to the other right heart outside the other normal. Fiberoptic bronchoscopy: bilateral bronchial mucosal congestion, swelling, smooth, double bronchus entrance white