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心包原发性肿瘤罕见报道,现将作者所见1例报告如下。 患者,男,73岁,因心前区不适,心悸1年余,面部浮肿,腹胀3个月于1992年1月21日入院。既往有高血压病史。患者于1年前走路时心前区不适,压迫感,休息后好转;近3个月来症状加重,面部浮肿,尿少,腹胀,无发热,咳嗽。曾在国外多家医院治疗,效果不显。查体:T36.5℃,HR72次/分,BP26/16kPa,颜面浮肿,颈静脉怒张,奇脉,心尖搏动不明显,心浊音界在左第5肋间锁骨中线外0.5cm,S_1降低,无杂音,律整,未闻心包摩擦音;双肺底湿性罗音,腹部膨隆,肝肋下4cm,质中,轻压痛,肝颈静脉回流征(+),有移动性浊音;双足背有凹陷性水肿;Hb110g/L,RBC3.8×10~(12)/L,血Cr 152.6μmol/L,大、小便常规正常;腹部“B”超:肝大伴少量腹水;ECG:窦性心律,室内传导阻滞;X光胸片:心包积液,胸腔积液;心脏“B”超:大量心包积液,
Primary tumors of the pericardium are rarely reported. One case reported by the author is reported below. The patient, male, 73 years old, was admitted to hospital on January 21, 1992 due to discomfort in the precordial area, palpitations for more than one year, facial edema, and abdominal distention for 3 months. Previous history of hypertension. When the patient walked a year ago, he felt uncomfortable in the precordial area, felt oppressed, and recovered after the rest. In the past 3 months, his symptoms worsened, his face was swollen, he had little urine, he had distention, he had no fever, and he had a cough. He has been treated in many hospitals abroad and the effect is not significant. Physical examination: T36.5°C, HR 72 beats/min, BP26/16kPa, facial edema, jugular venous engorgement, odd pulse, apical beat is not obvious, murmur voiced circle is 0.5cm out of the left fifth intercostal clavicle midline, S_1 decreased ,No noise, Regularity, no pericardial fricative sounds; Wet rales at the bottom of the lungs, bulging abdomen, 4 cm below the liver, qualitative, light tenderness, hepatic jugular venous return sign (+), with shifting dullness; Depressed edema; Hb110g/L, RBC3.8×10~12/L, blood Cr 152.6μmol/L, regular urine and urine; abdomen “B” super: hepatomegaly with small ascites; ECG: sinus rhythm , Indoor conduction block; X-ray chest: pericardial effusion, pleural effusion; heart “B” super: a large number of pericardial effusion,