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患者男,70岁,因反复心慌、胸闷、气喘、咳痰、胸骨后不适半月,拟慢支、肺气肿、肺心病房颤入院。查体:血压22/10.6kPa,消瘦,口唇轻度紫绀,桶状胸,剑突下见收缩期搏动。心率86次/分,心律绝对不齐,P_2>A_2,各瓣膜未闻器质性杂音,剑突部心音增强。双肺呼吸音粗糙。腹软,肝肋下1.5cm,质地稍韧。下肢无浮肿,余(一)。辅助检查:胸片示有下肺动脉增宽为1.6cm。心电图示窦性心律,肺型P波,频发房性早搏。4h后转为房颤,室率平均100次/分。
Male, 70 years old, due to repeated palpitation, chest tightness, asthma, sputum, discomfort after half a month, to be chronic bronchitis, emphysema, pulmonary heart disease atrial fibrillation admission. Physical examination: blood pressure 22 / 10.6kPa, weight loss, lips mild cyanosis, barrel chest, xiphoid see systolic beats. Heart rate 86 beats / min, the heart rhythm is absolutely not Qi, P_2> A_2, the valve is not unheard of organic murmur, xiphoid heart sound enhancement. Breathing sounds rough lungs. Abdomen soft, liver ribs 1.5cm, slightly tough texture. Lower extremity without edema, Yu (a). Auxiliary examination: the chest showed the lower pulmonary artery widened to 1.6cm. ECG shows sinus rhythm, pulmonary P wave, frequent atrial premature beats. 4h after the conversion to atrial fibrillation, room rate average 100 beats / min.