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例1,男,54岁,因咳喘10余年,加重2天于1989年11月12日入院.查体:血压17/10kPa,端坐位,口唇紫绀,颈静脉怒张,桶状胸,叩诊过清音,双肺满布哮鸣音,心率120次/分,律规整无杂音,肝肋下2cm,轻触痛,下肢无浮肿.初步诊断:慢性喘息性支气管炎急性发作.立即给鼻导管吸氧,静滴青霉素、氨茶碱及地塞米松.治疗1天后,喘憋无缓解,又试用异丙基肾上腺素,因病人心慌不能耐受而停药.再查体时发现右侧呼吸音略低,即行X线检查,示:右侧气胸(肺压缩40%).经胸腔穿刺抽气后,患者呼吸困难即刻明显缓解.
Example 1, male, 54 years old, due to cough and asthma more than 10 years, aggravating 2 days admitted on November 12, 1989. Physical examination: blood pressure 17 / 10kPa, sitting position, cyanotic lips, jugular vein engorgement, Over voiceless, lungs covered with wheeze, heart rate 120 beats / min, the law no noise, liver ribs 2cm, tenderness, lower extremity no edema .A preliminary diagnosis: chronic asthmatic bronchitis acute attack.And immediately to the nasal cannula Oxygen, intravenous infusion of penicillin, aminophylline and dexamethasone.After 1 day of treatment, wheezing without remission, and try isopropyl epinephrine, because the patient can not tolerate palpitation and withdrawal. Slightly lower, that line X-ray examination, showed: the right pneumothorax (pulmonary compression 40%) .Thoracic aspiration, patients with immediate relief of respiratory distress.