论文部分内容阅读
女,48岁。7天前起畏寒、发热、鼻塞、咽痛和肌痛,第三天起左胸阵发性疼痛,活动时加剧并伴心慌气促。既往无高血压、心脏病史。查体:体温36.8℃,脉搏118,呼吸24,血压90/60。稍气促,唇微绀,无黄疸;咽充血;颈静脉充盈。肺无异征;心尖弥漫搏动于左5肋间锁中线外2cm,心律齐,心尖区有Ⅱ级收缩期吹风性杂音,胸骨左缘3～4肋间可闻心包摩擦音。肝右肋下3cm,质中边钝有触痛,肝—颈回流征阳性,脾(-);下肢轻度水肿。化验:白细胞8600,中性76％,淋巴24％CO_2CP 38.1Vol％,血钾6.1mEq/L;钠144.8mEq/L;血沉4mm,抗链“O”500u。胸透心界向
Female, 48 years old. 7 days ago chills, fever, nasal congestion, sore throat and myalgia, paroxysmal left chest pain from the third day, aggravating activity and with palpitation. No previous history of hypertension, heart disease. Physical examination: body temperature 36.8 ℃, pulse 118, breathing 24, blood pressure 90/60. Slightly shortness of breath, lip cyanosis, no jaundice; pharyngeal congestion; jugular vein filling. No signs of lung; apical diffuse pulsation in the left 5 intercostal lock line 2cm, heart rate Qi, apical symphysis stage Ⅱ blowing noise, sternal left intercostal 3 to 4 can be seen in the intercostal pericardial fricative. Liver right rib 3cm, quality of the side of the blunt tenderness, liver - neck reflux sign positive, spleen (-); lower extremity mild edema. Laboratory: white blood cells 8600, 76% neutral, lymph 24% CO_2CP 38.1Vol% potassium 6.1mEq / L; sodium 144.8mEq / L; ESR 4mm, anti-chain “O” 500u. Chest through the heart to the heart