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病人 女,71岁。因咳嗽、咳痰、间断性痰中带血6个月加重20天入院。胸部X线检查:两侧胸廓不对称,脊柱侧弯,右上肺野内侧见密度增浓影,其周围见条状模糊影,纵隔气管右移。侧位片见右肺上叶体积缩小,左肺未见实变。X线印象:右肺上叶癌,肺不张,右旋心?心电图检查:窦性心律,不正常心电图,冠状供血不足。CT检查:右肺中心型肺癌伴阻塞性炎症,右胸腔积液。临床以右上叶中心型肺癌提请支气管镜检查。 纤支镜进入左右支气管观察发现:左肺有三个叶开口,距隆凸约1.5cm支气管外前壁见上叶开口,开口内见各段开口。继续进镜见中叶开口外下方有下叶开口,下叶背段开
Patient Female, 71 years old. Because of cough, sputum, intermittent sputum, blood was admitted for 6 months and hospitalized for 20 days. Chest X-ray examination: on both sides of the chest asymmetry, scoliosis, the upper right side of the lung field to see the density increase thick shadow, around it to see a strip of blurred shadow, the right lateral tracheal trachea. In the lateral view, the volume of the right upper lobe was reduced, but the left lung was not changed. X-ray impression: right upper lobe cancer, lung atelectasis, right heart spine? Electrocardiogram: sinus rhythm, abnormal electrocardiogram, coronary insufficiency. CT examination: Right lung center type lung cancer with obstructive inflammation, right pleural effusion. Clinically, lung cancer of the right upper lobe was used for bronchoscopy. The bronchoscope was observed in the left and right bronchus. The left lung had three leaf openings. About 1.5 cm away from the bulge, the bronchial anterior wall was seen in the upper leaf opening, and each opening was seen in the opening. Continue to enter the mirror and see the lower leaf opening below the opening, the lower leaf segment opens