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患者女,24岁,因咳嗽6个月、声嘶3个月、呼吸困难2个月入院。患者自2006年4月起无明显诱因出现咳嗽,咳少许稀白痰,伴食欲不振、体重下降,无发热、盗汗、咯血等症状。2006年7月起在原有症状基础上出现声嘶,当地医院诊断为咽喉炎,治疗后症状无缓解。2006年9月起出现呼吸困难,且呈进行性加重,再次在当地医院就诊,抗感染治疗后症状仍未缓解,经 X 线胸片诊断为肺结核转入我院。既往健康。入院时体检:体温36.5℃,心率88次/min,呼吸24次/min,血压110/70 mm Hg(1 mm Hg=0.133 kPa)。精神疲倦,乏力,口唇轻微发绀,浅表淋巴结未触及肿大,胸部叩诊左下部呈浊音,双肺呼吸音减弱,可闻及散在湿啰音。心脏听诊未见异常。实验室检查:血白细胞计数及中性粒细胞偏高,尿、便常规及生化检查均无异常。血气分析结果显示
Female patient, 24 years old, cough for 6 months, hoarseness for 3 months, breathing difficulties 2 months admitted to hospital. Patients since April 2006 no obvious incentive cough, cough lean sputum, with loss of appetite, weight loss, no fever, night sweats, hemoptysis and other symptoms. Since July 2006, there was hoarseness on the basis of the original symptoms. The local hospital diagnosed as laryngitis and the symptoms did not relieve after treatment. Respiratory dysfunction occurred in September 2006, and was progressive increase again in the local hospital for treatment, the symptoms after anti-infective treatment has not been alleviated, the diagnosis of tuberculosis by X-ray into our hospital. Past health. Physical examination on admission: body temperature 36.5 ° C, heart rate 88 beats / min, breath 24 breaths / min, blood pressure 110/70 mm Hg (1 mm Hg = 0.133 kPa). Mental fatigue, fatigue, slight cyanosis of the lips, superficial lymph nodes did not touch the swelling, the lower left percussion was voiced, lung breath sounds weakened, can be heard and scattered wet rales. Cardiac auscultation no abnormalities. Laboratory tests: white blood cell count and high neutrophils, urine, routine and biochemical tests were normal. Blood gas analysis results show