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患者男,32岁,因转移性右下腹痛5天伴畏寒、发热等,诊断为“急性阑尾炎”于1983年5月4日入院。患者慢性肾小球肾炎病史18年。体检:痛苦病容,重度贫血貌,气急,烦燥,无紫绀。体温37.4℃,血压180/100,心率120次,心尖区闻及舒张期奔马律,两肺闻干鸣音。右下腹麦氏点压痛及反跳痛明显。实验室检查:血红蛋白2.8g,红细胞200万,BUN128mg%,Cr12mg%,CO_2-CP9.9V%。尿常规;脓细胞、红细胞极少,蛋白(?),未发现管型。X 线后前位胸片示:两肺满布大小不等结节状球形阴影,直径0.5～4.0cm,病变多集中在两肺中、内带肺门附近之中下肺野,其轮廓可见,但不够锐利,密度较高,左肺部分病变边缘模糊不清。心影略向左侧增大,心尖部向左下延伸见插页图1).
Male, 32 years old, diagnosed as “acute appendicitis” on May 4, 1983, due to metastatic right lower quadrant with 5 days with chills and fever. Chronic glomerulonephritis in patients with a history of 18 years. Physical examination: painful illness, severe anemia appearance, shortness of breath, irritability, no cyanosis. Body temperature 37.4 ℃, blood pressure 180/100, heart rate 120 times, apex area smell and diastolic gallop, both lung smells dry. Right lower quadrant abdominal pain and rebound tenderness significantly. Laboratory tests: hemoglobin 2.8g, 2 million red blood cells, BUN128mg%, Cr12mg%, CO_2-CP9.9V%. Urine routine; pus, very few red blood cells, protein (?), Found no tube type. X-ray chest radiograph showed: two lungs covered with nodules ranging in size ranging from spherical shadow, diameter 0.5 ~ 4.0cm, lesions are more concentrated in the two lungs, with the lung in the vicinity of the middle and lower lung field, the outline of the visible , But not sharp enough, high density, left lung lesions edge fuzzy. Heart shadow slightly increased to the left, apical extension to the left to see insert Figure 1).