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患男,54岁。咳嗽,多痰,喉咽痒感和呛咳1年,加重半年。门诊拍胸片见右心隔角处片块状阴影。纤维支气管镜检查发现右肺中间支气管外侧壁有3个结节状肿物,突出于管腔内,故以“肺癌”于1991年7月26日收住兰州医学院第一附属医院。查体:体温、脉搏、呼吸、血压均正常。营养佳,无紫绀。右肺中下呼吸音明显减弱,余未见异常。住院后再次行纤维支气管镜检查,见前次相同部位肿物周围组织坚韧,脓性分泌物较多,取肿物组织病检为慢性炎症改变,未找到肿瘤细胞。X线透视下见右肺门下方片块阴影内有密度较高的异物,形似牙齿,随呼吸运动,疑义齿误入支气管。复习7月19日门诊胸片,见密度较高影内有一金属环状物。追述病史,患者于90年5月“感冒”,打喷嚏后,一颗义齿不翼而飞。当时未有其他异常感觉,半月后出现咳嗽,伴咳脓痰症状。获此病史后第3次做纤维支气管镜检查,见右中间支气管内有金属异物被组织包裹,因异物较大,反复多次钳取未能成功。当日晚10时患者连续
Male, 54 years old. Cough, phlegm, throat and itchiness and cough for 1 year, aggravating six months. Out-patient beat chest radiographs see the shadow block at the right angle. Fiberoptic bronchoscopy found that the right middle lung bronchial outer wall has 3 nodular tumor, prominent in the lumen, it is “lung cancer” on July 26, 1991 admitted to Lanzhou Medical College First Affiliated Hospital. Physical examination: body temperature, pulse, respiration, blood pressure are normal. Good nutrition, no cyanosis. Lower right lung breath sounds significantly lower, I no abnormalities. After hospitalization again fiberoptic bronchoscopy, see the same time ago the same parts of the tumor around the tough tissue, purulent secretions more, take the tumor tissue examination for chronic inflammation, did not find the tumor cells. X-ray see the right hilum below the block shadow high density foreign body, shaped like a tooth, with respiratory movement, the misunderstanding into the bronchus. Review July 19 outpatient chest radiography, see the shadow of a higher metal shadow ring. Recalling the medical history, patients in May 90, “cold”, after sneezing, a denture missing. At that time there was no other abnormal feeling, cough after half a month, cough with purulent sputum symptoms. After this history of the third bronchoscopy, see the middle of the right bronchial metal foreign body was wrapped in tissue, due to the larger foreign body, repeatedly failed to clamp several times. The patient was continuous at 10 o’clock on the same day