论文部分内容阅读
临床讨论 Majerus:讨论的是一位消瘦住养老院的83岁白种女病人。死前一周发现病者昏迷而送至某医院。血压160/104mmHg,脉率112/min,体温99.7°F,呼吸20/min。黄疸,多处挫伤和瘀斑,可能有肝大,大便潜血阳性。诊断为弥散性血管内凝血(DIC),而转到Barnes医院。胸部X线显示肺部浸润,无其他心力衰竭的临床证据。给与氯洁霉素。氧哌嗪青霉素、妥布霉素和肝素1,000U/h,于3天后死亡。 Jost:可惜这些X线照片对本例没有很多的帮助。心脏增大,肺纹理明显,双侧胸腔积液。在大多数病人,这些表现提示充血性心力衰竭。但Majerus医生告诉我们,本例并无充血性心力衰竭充分的临床证据。这些X线表现无特殊性,如果临床较似恶性肿瘤
Clinical Discussion Majerus: Discussed a 83 year old Caucasian female who lost weight in nursing homes. A week before his death, the patient was found unconscious and sent to a hospital. Blood pressure 160 / 104mmHg, pulse rate 112 / min, body temperature 99.7 ° F, breathing 20 / min. Jaundice, multiple bruises and ecchymosis, may have liver, fecal occult blood positive. Diagnosis of disseminated intravascular coagulation (DIC), and go to Barnes Hospital. Chest X-ray showed pulmonary infiltration, no other clinical evidence of heart failure. Give clindamycin. Piperacillin, tobramycin and heparin 1,000 U / h, died after 3 days. Jost: Unfortunately, these X-rays do not help much in this case. Heart enlargement, lungs obvious, bilateral pleural effusion. In most patients, these manifestations suggest congestive heart failure. However, Dr. Majerus tells us that there is no adequate clinical evidence of congestive heart failure in this case. These X-ray showed no particularity, if clinically more like malignancy