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病历摘要:女性,38岁。5个月前出现左前胸部及腋下针刺样疼痛,向左肩背部放散。有干咳气急,无发冷发热。起病后二个月症状加重并痰中带血,某医院诊断为“左侧结核性胸膜炎伴胸腔积液”,作抗结核治疗3个月无好转而来我院内科。体格检查:一般情况尚可,全身浅表淋巴结未触及,血压130/80mmHg,左侧呼吸运动减弱,呼吸音明显减低,无胸膜摩擦音及罗音。实验室检查:血红蛋白13.3g,白细胞11600,中性分叶800%,淋巴15%,嗜酸性3%;尿常规正常;血沉61mm/h。胸水常规为淡黄色,微混,比
Medical record summary: Female, 38 years old. A left acupuncture-like pain in the left anterior chest and armpits appeared 5 months ago and was dissipated to the left shoulder and back. Have dry cough, no fever. Two months after the onset of symptoms and bloody sputum, a hospital diagnosed as “left tuberculous pleurisy with pleural effusion” for 3 months without anti-TB treatment without improvement in our hospital. Physical examination: the general situation is acceptable, systemic superficial lymph nodes not touched, blood pressure 130 / 80mmHg, left respiratory motion decreased, significantly reduced respiratory sounds, no pleural friction and rales. Laboratory tests: hemoglobin 13.3g, white blood cells 11,600, 800% neutral, lymphatic 15%, 3% eosinophils; normal urinary tract; ESR 61mm / h. Pleural fluid is light yellow, slightly mixed, than