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病史简介苏×,女,56岁,已婚,演员。住院号149022。于1980年2月20日因腹胀、纳减,消瘦2月,发热、咳嗽、痰多1月入院。患者自1979年底起,腹胀,纳减。1980年1月24日突有畏寒、发热,体温38.8℃,用青、庆大霉素治疗。超声波检查:肝剑突下、肋下各1.5cm,较密微波,腹水(一),因出现咳嗽、痰多,1月28日胸透:左胸腔积液。抽胸水2次(280及220ml),常规检查:比重1.020,Rivalta试验(±),红细胞5,050/μl,白细胞1,160/μl.单核83％,多核17％,蛋白定量2,740mg/dl,抗酸杆菌(一)。至2月初,转为低热,拟诊“结核性胸膜炎”,改用链霉素、异菸肼治疗。因疗效不佳,出现胸闷、气促,且日益消瘦,收入肺科病房。
Brief history of the case Su ×, female, 56 years old, married, actor. Hospital number 149022. On February 20, 1980 due to bloating, reduction, weight loss in February, fever, cough, phlegm January admission. Patients from the end of 1979, bloating, reduction. January 24, 1980 sudden chills, fever, body temperature 38.8 ℃, with green, gentamicin treatment. Ultrasound: liver xiphoid, ribs 1.5cm, more dense microwave, ascites (a), due to cough, phlegm, January 28 thoracotomy: left pleural effusion. (280 and 220 ml) were aspirated twice a day (280 and 220 ml). Routine tests (Rivalta test, ± 5,050 / μl, white blood cells, 1,160 μl / Bacillus (a). To early February, turned to fever, diagnosis of “tuberculous pleurisy”, switch to streptomycin, isoniazid treatment. Due to poor efficacy, chest tightness, shortness of breath, and increasingly weight loss, income pulmonary ward.