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病例报告 患者,男,67岁,农民。因反复咳嗽、咳痰伴气喘30年,症状加重10d,于1988年8月12日入院。入院前未做系统治疗。患者无水肿、心绞痛和夜间阵发性呼吸困难史,无高血压、糖尿病史。检查:体温36℃,呼吸24次,脉搏92次,血压14.1/10kPa,消瘦。肺气肿征,双肺散在哮鸣音和湿罗音。心界不大,心率92次,律整,P_2>A_2,各瓣膜区无杂音。肝、脾未触及。下肢无浮肿。血气pH7.38、PO_27.98kPa、Pco_26.69kPa、BE+1.6mEq/L。血常规、电解质、血脂、空腹血糖均正常。胸相示慢支、肺气肿并感染,右肺下动脉干无增宽,心影不大。入院诊断(1)喘息型慢性支气管炎;
Case report patient, male, 67 years old, farmer. Due to repeated cough, sputum with asthma for 30 years, the symptoms increased 10d, admitted on August 12, 1988. No systematic treatment before admission. Patients without edema, angina and nocturnal paroxysmal dyspnea history, no hypertension, history of diabetes. Check: body temperature 36 ℃, breathing 24 times, pulse 92 times, blood pressure 14.1 / 10kPa, weight loss. Emphysema sign, lungs scattered wheeze and wet rales. Heart, 92 heart rate, rhythm, P_2> A_2, the valve area without noise. Liver, spleen not touched. Lower extremity without edema. Blood gas pH7.38, PO_27.98kPa, Pco_26.69kPa, BE + 1.6mEq / L. Blood, electrolytes, blood lipids, fasting blood glucose were normal. Chest said slow, emphysema and infection, no expansion of the right pulmonary artery, heart shadow. Admission diagnosis (1) wheezing chronic bronchitis;