患者,男,58岁。因消瘦、胸闷1月余,呕吐、痰中带血丝10 d入院。门诊胸片显示:右侧胸腔积液,右上肺占位性病变。外院CT提示:右肺恶性肿瘤,右锁骨上淋巴结有转移迹象。超声定位后,首次胸穿抽胸水共抽出棕黄色浑浊胸液1 080 ml,术后患者胸闷、气短明显好转,无明显不适。5 d后进行第2次胸穿抽胸水,抽出深黄色浑浊胸水1 740 ml后向胸腔内注射博来霉素(日本化药株式会社,批号:480880)45 mg,以期控制肿瘤及胸水。术后4 h患者出现高热寒战,最高体温达39.7℃,立即给予地塞米松10 mg iv,异丙嗪注射 Patient, male, 58 years old. Due to weight loss, chest tightness in more than 1 month, vomiting, sputum with blood stained 10 d admission. Outpatient chest X-ray showed: right pleural effusion, right upper lung space-occupying lesions. Outside the hospital CT tips: Right lung cancer, right supraclavicular lymph node metastasis signs. Ultrasound localization, the first chest drainage pleural effusion were out of brown turbid turbid fluid 1 080 ml, postoperative chest tightness, shortness of breath significantly improved, no obvious discomfort. Five days later, a second pleural effusion was performed, and a deep yellow turbid pleural effusion (1 740 ml) was drawn into the chest for injection of bleomycin (Nippon Kayaku Co., Ltd., Lot No. 480880) 45 mg in order to control the tumor and pleural effusion. 4 h after surgery, patients with fever chills, the highest temperature of 39.7 ℃, dexamethasone immediately given 10 mg iv, promethazine injection