论文部分内容阅读
患者女,78岁,入院前3月因受凉后发热、咳嗽、咯痰,咯血2次,共约100ml,在当地就医,症状减轻,但随之出现心悸、气促,仍有发热、咳嗽,入院前2天病情加重,伴双下肢水肿而来我院就诊。查体,T38.6℃,颈静脉充盈,双肺气肿征,双肺散在湿罗音。心界不大,无震颤,心率130次/分,律不齐,可闻及早搏4～6次/分,心尖区闻及吹风佯收缩期杂音Ⅱ/Ⅵ级,肝肋下2cm,双下肢凹陷性水肿,轴助检查,Hb9.6g/L WBC12.5×10~4/L,N0.85,L 0.15。心电图示窦速、房早伴差异性传导。胸片示慢支炎、肺气肿、双肺间质广泛炎变。入院后给予抗感染,补充电解质及对症治疗,病情无明显好转,入院后第5天自觉
Female patient, 78 years old, 3 months before admission due to cold after the fever, cough, expectoration, hemoptysis 2 times, a total of about 100ml, in the local medical treatment, the symptoms alleviate, but there palpitations, shortness of breath, fever, cough, 2 days before admission, exacerbations, with double lower extremity edema came to our hospital. Physical examination, T38.6 ℃, jugular vein filling, pulmonary emphysema sign, lungs scattered in wet rales. Small heart, no tremor, heart rate 130 beats / min, irregularities, can be heard and premature beats 4 to 6 beats / min, apical area smell and hair feint systolic murmur Ⅱ / Ⅵ, hepatic ribs 2cm, Depression edema, axial examination, Hb9.6g / L WBC12.5 × 10 ~ 4 / L, N0.85, L0.15. ECG shows sinus speed, room early with different sex conduction. Chest radiograph showed chronic bronchitis, emphysema, extensive interstitial inflammatory changes. Admitted to hospital after anti-infective, electrolyte replacement and symptomatic treatment, no significant improvement in condition, conscious after 5 days of admission