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1 病历介绍 患者,男,53岁,以颈胸部静脉曲张伴面颈部肿胀1月为主诉于1996年5月16日入院。1月前无明显诱因出现颈胸部静脉曲张,面颈部肿胀、变粗、头痛、头晕;伴心慌、气短,无心前区疼痛,在某医院诊断为“冠心病”,治疗后效果不明显。7天前,颈胸部静脉明显曲张伴面颈部浮肿,声音嘶哑,吞咽困难,头痛,夜休差,明显消瘦,无发热,咳嗽、咳痰及咳血;无恶心、呕吐;无腹痛、腹泻;大小便正常。既往体健,20岁开始吸烟至今,日10～20支。查体:T36.6℃,P96次/分,R20次/分,BP10/10kPa。神志清,面颈部浮肿,双上肢轻度浮肿,颈及胸上部浅静
1 medical history introduced patients, male, 53 years old, with cervical and thoracic varicose veins with neck swelling in January as the main complaint on May 16, 1996 admission. No obvious cause of cervical and thoracic varicosity, facial swelling, thickening, headache, dizziness, palpitation, shortness of breath, no precordial pain, and “coronary heart disease” were diagnosed in a hospital after 1 month. The effect was not obvious after treatment. 7 days ago, the neck and thoracic veins were varicose with face and neck edema, hoarseness, dysphagia, headache, night off, marked weight loss, no fever, cough, sputum, and hemoptysis; no nausea and vomiting; no abdominal pain, diarrhea ; urine is normal. Previously healthy, 20-year-old began to smoke so far, day 10 to 20. Physical examination: T36.6°C, P96 beats/min, R20 beats/min, BP10/10kPa. Clear mind, edema of face and neck, slight swelling of both upper limbs, shallow upper neck and upper chest