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1 病例报告 患者,男,16岁,农民,于1999年9月26日感发热,呼吸困难,在乡村卫生室诊治。述当时体温在39℃,给肌注安痛定退烧,并给肌注庆大霉素8万单位,每日2次,病毒唑每日200mg,分2次肌注。于9月28日,病人呼吸困难加重、全身出汗、发烧、乏力,遂急诊来院。既往患慢性支气管炎病史20年,门诊以“慢性支气管炎急性发作”吸入院。体检:T38.5℃、P96次/分、R30次/分、BP130/90mmHg,神清,憋喘貌,全身皮肤潮湿,无皮疹及出血,浅表淋巴结未触及肿大,口唇轻度紫绀,桶状胸,双肺呼吸音低,可闻及少量哮鸣音,心律齐,心音有力,各听诊区无杂音,腹部软,肝肾区无叩击痛,肋下未触及肝脾,下肢不浮肿。实验室检查:血常规WBC11.6×10~9/L、RBC4.21×10~(12)/L、HGB133g/L、PLT77×10~9/L、LY7.3％、GR90.2％、MO2.5％,肝功能ALT82单位,尿常规白蛋白+,胸部X线片见双肺纹理增粗紊乱,心电图示窦性心律,部分导联ST段压低。入院诊断:慢性支气管炎急性发作。经给青霉素800万单位分两次静点,环丙沙星0.2克静
1 case report Patients, male, 16 years old, farmer, on September 26, 1999 a fever, difficulty breathing, diagnosis and treatment in rural clinics. The body temperature at 39 degrees Celsius, to intramuscular injection of analgesic fever, and intramuscular injection of gentamicin 80,000 units, 2 times daily, ribavirin daily 200mg, 2 times intramuscular injection. On September 28, the patient became more dyspnoea, sweating, fever and fatigue. He then came to the hospital for emergency treatment. Past history of chronic bronchitis history of 20 years, outpatient “chronic bronchitis attack” inhaled. Physical examination: T38.5 ℃, P96 beats / min, R30 beats / min, BP130 / 90mmHg, Shen Qing, suffocating body appearance, systemic skin moist, no rash and hemorrhage, superficial lymph nodes did not touch swollen, mild cyanosis lips, Barrel-shaped chest, lungs breath sounds low, can be heard and a small amount of wheeze, Qi Qi, heart sounds strong, no noise in the auscultation area, abdominal soft, perling zone without percussion pain, ribs did not touch the liver and spleen, lower extremity edema. Laboratory tests: blood WBC11.6 × 10 ~ 9 / L, RBC4.21 × 10-12 / L, HB133g / L, PLT77 × 10 ~ 9/L, L7.3%, GR90.2% MO2.5%, liver function ALT82 units, urinary albumin +, chest X-ray film to see double lungs thickening disorders, ECG showed sinus rhythm, ST-segment depression. Admission diagnosis: acute exacerbation of chronic bronchitis. After the penicillin 800 million units in two static points, ciprofloxacin 0.2 grams of static