1.临床资料 患者,女,58岁,农民。主诉:不能进食,进食后即咳呛,呕吐半月。现病史:起病缓,患者三年前患脑血栓偏瘫后、经治疗好转,生活能自理,走路缓慢,说话吐字不清,近半月来,因患“感冒”咳嗽、食后咳呛,曾在村卫生所诊断为“肺炎”,经输液、注射青霉素,病情未见好转,食后咳呛、呕吐进一步加剧,于1999.4.15日来我院门诊就医。体格检查,体温:36.8℃、脉搏90次/分、 1. Clinical data Patient, female, 58 years old, farmer. Chief complaint: Can not eat, cough after eating, vomiting for half a month. History of illness: Slow onset, patients with cerebral thrombosis after three years ago, hemiplegia, improved after treatment, life can take care of themselves, walk slowly, speak unclear words, in the past half months, suffering from “cold” cough, cough after eating, had After being diagnosed as “pneumonia” at the village clinic, the condition was not improved after infusion or injection of penicillin. Cough and vomiting were further aggravated after eating. He came to our hospital for treatment on 1999.4.15. Physical examination, body temperature: 36.8°C, pulse 90 beats/minute,