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临床讨论Cryer 医师:这位65岁老年病人呈现多方面临床问题。包括急性和慢性肺部病变,酗酒史,恶性疾病,营养不良,低钠血症及空腹时低血糖症。现请Jost 医师介绍 X 线检查的发现。Jost 医师:住院前6个月的胸片显示横膈低平和肺大疱性肺气肿,与慢性阻塞性肺部疾患的改变相符。还发现一些陈旧性肋骨骨折,导致同侧肋膈角变钝。入院时仰卧位胸片在右肺基底部新发现一非特异性浸润性典型肺炎病灶。在一位明显消瘦的病人,应考虑肿瘤所致的浸润灶。例如阻塞性支气管内膜肿瘤时下肺叶易发生肺炎。但对此神志不清病人,我认为此
Clinical Discussion Dr Cryer: The 65-year-old patient presents with a wide range of clinical problems. Including acute and chronic lung disease, alcoholism, malignant diseases, malnutrition, hyponatremia and fasting hypoglycemia. Dr. Jost is invited to introduce X-ray findings. Dr. Jost: Chest radiographs at 6 months before hospitalization showed low diaphragm and bullous emphysema consistent with changes in chronic obstructive pulmonary disease. Also found some old rib fractures, leading to ipsilateral costophthalmos angle dull. Admission supine chest radiograph in the bottom of the right lung found a non-specific invasive typical pneumonia lesions. In an obviously thin patient, should consider the tumor caused by infiltration stove. For example, obstructive bronchial endometrial tumors prone to pneumonitis. But for this unconscious patient, I think this