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例1 赵×,男,59岁,某化工厂厂长。自诉从1980年7月23日起,无何明显诱因的发热(体温最高38℃)、乏力、纳差、全身关节酸痛、轻咳、少痰等,经门诊对症治疗效果不佳。7月底在某医院拍胸片,拟诊“左上肺结核”,于1980年8月6日入我院。既往史:1949年患过肺结核,1973年、1975年曾两次患过肺炎(右下肺、左中肺)。有中等量吸烟嗜好。1980年6月曾作胸部透视复查未见异常。体检:体温37.4℃,脉搏84次/分,血压120/80mmHg,左上胸部叩诊稍浊,可闻少许湿性罗音,余无异常。化验:白细胞总数7,900,中性67%,淋巴33%;血沉61mm/第1小时;尿、粪常规(一);冷凝集试验1:16;痰检未见抗酸杆菌。8月14日胸片见左第一前肋先天性缺如,两肺纹理增粗,左肺上、中部有不规则、密度不均匀的大片状阴影,左第三前肋处病灶似团块状,左肺门区有钙化影,左肋膈角稍变钝(图1见封三,下同)。断层
Example 1 Zhao ×, male, 59 years old, director of a chemical plant. Private prosecution from July 23, 1980, no obvious incentive for fever (body temperature up to 38 ℃), fatigue, anorexia, body soreness, light cough, less sputum, the outpatient symptomatic treatment ineffective. By the end of July in a hospital shot chest X-ray, proposed diagnosis of “upper left pulmonary tuberculosis”, on August 6, 1980 into our hospital. Past history: In 1949, we had tuberculosis. In 1973, we had pneumonia twice in 1975 (lower right lung, left middle lung). Have moderate smoking habit. June 1980 chest X-ray examination for no abnormalities. Physical examination: body temperature 37.4 ℃, pulse 84 beats / min, blood pressure 120 / 80mmHg, percussion slightly turbid left upper chest, can smell a little wet rales, I no exception. Assay: The total number of leukocytes 7,900, 67% neutral, lymphatic 33%; erythrocyte sedimentation rate 61mm / first hour; urine, fecal routine (a); cold agglutination test 1:16; sputum no acid-fast bacilli. On August 14 thoracic see the first left anterior abdomen congenital absence, thickening of the two lungs, the left lung, the central irregular, uneven density of large shadows, the left third anterior rib lesions like group Massive, left hilar area calcification, left marginal diaphragmatic angle slightly blunt (see Figure 1 seal three, the same below). Fault