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患者徐某某,男性、54岁、南昌人、干部。因咳嗽、咳痰、气紧、心悸、下肢浮肿而于76年4月20号入院。既往有20余年的支气管哮喘史和七年的慢肝病史。体查:体温37.8℃,脉搏120次/分,呼吸32次/分,血压130/90毫米汞柱,神智清楚,端坐呼吸,口唇发绀,鼻翼扇动,皮肤灰暗,杵状指,颈静脉怒张,桶状胸廓,两肺呼吸音显著减弱,有广泛的干性啰音,肺底有小水泡音,心尖搏动在剑突下偏左,无明显杂音,心率快而有偶发的期前收缩,肝及四横指,质中,有轻压痛,肝颈静脉逆流征阳性、腹水征阳性。心电图意见:(1)QRS波群低电压,(2)右心室肥厚,(3)顺钟向转位,(4)肺型P波。X线透视:两肺透亮度增加,横隔下降,肺动脉圆椎明显突出。临床诊断:1.支气管哮喘,2.肺气肿,3.肺源性心脏病合并感染。
Xu Moumou patients, men, 54 years old, Nanchang, cadres. Due to cough, sputum, tightness, heart palpitations, lower extremity edema and in April 20, 76 admission. Past history of bronchial asthma more than 20 years and seven years history of chronic liver disease. Physical examination: body temperature 37.8 ℃, pulse 120 beats / min, breathing 32 beats / min, blood pressure 130/90 mm Hg, clear mind, sitting and breathing, lips cyanosis, nose flap, dark skin, clubbing, Zhang, barrel thoracic, lung breath sounds significantly weakened, there are a wide range of dry rales, lung a small blisters sound, apex beat in the xiphoid left, no obvious noise, fast heart rate and occasional premature contraction , Liver and four cross refers to the quality of light tenderness, liver jugular vein reflux positive, ascites sign positive. ECG views: (1) QRS complex low voltage, (2) right ventricular hypertrophy, (3) cis-translocation, (4) pulmonary P wave. X-ray: the two lungs increased brightness, decreased septum, prominent pulmonary spine. Clinical diagnosis: 1. Bronchial asthma, 2. Emphysema, 3. Pulmonary heart disease with infection.