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討論 (一)診断部份本例患者在起病前有外伤史,繼以發冷,發热及左膝关节腫脹,疼痛等,其主要临床表現有: (1)發热:入院前十天与关节疼痛的同时即有畏寒、發热現象,热型为敗血型,在院外虽經青霉素及磺胺剂治疗,未見进步。 (2)左侧膝关节有进行性之紅、腫、热、痛现象,鄰近粗織亦受牽累,显示关节腔的急性炎症变化日漸加剧。 (3)患者取半臥位,心臟濁音界向兩侧扩大,有心包摩擦音,肝臟腫大一横指、質軟、無压痛。
Discussion (a) of the diagnosis part of the patients before the onset of a history of trauma, followed by chills, fever and left knee joint swelling and pain, the main clinical manifestations are: (1) fever: 10 days before admission At the same time with the pain in the joints that have chills, fever, fever type for the septicemia, although in hospital by penicillin and sulfonamides treatment, no progress. (2) The left knee joint has progressive red, swollen, hot and painful phenomena. The adjacent coarse wefts are also implicated, showing that the acute inflammatory changes in the joint cavity are aggravating. (3) patients take semi-recumbent position, the heart of the voiced sound sector to expand on both sides, a pericardial frictional sound, a liver enlargement refers to the fingers, soft, no tenderness.