论文部分内容阅读
患者女,49岁。因全身关节疼痛4年,心悸气促8个月,腹胀少尿15天入院。体查:体温37℃,脉搏98次,呼吸24次,血压14.6/9.2kPa、慢性重病容,贫血貌,被动体位。颈静脉不充盈,甲状腺不肿大。右下肺基底部可闻少许细湿罗音。心界左下扩大,无震颤,心率98次,早搏1～3次/分,心尖区Ⅲ°收缩期吹风样杂音及舒张期隆隆样杂音,P_2>A_2,周围血管征(一)。腹软,肝右肋下1cm,质中,脾左肋下3.5cm,轻触痛。肝颈远流征(+)。四肢各关节均呈梭形,伴肿痛及活动障碍,枕骨及双侧肋骨,左右骼骨,背部均可触及多个骨性结节。双下肢轻度凹陷性水肿。
Female patient, 49 years old. 4 years due to systemic joint pain, palpitations, shortness of breath 8 months, abdominal distension and oliguria 15 days admitted. Physical examination: body temperature 37 ℃, pulse 98 times, breathing 24 times, blood pressure 14.6 / 9.2kPa, chronic severe disease, anemia appearance, passive position. Jugular vein is not full, the thyroid is not swollen. Lower right lung base can smell a little wet rales. Heart left lower expansion, no tremor, heart rate 98 times, premature beats 1 to 3 beats / min, apical ¢ ò systolic hair-like murmur and diastolic rumbling noise, P_2> A_2, peripheral vascular sign (a). Abdominal soft, right rib 1cm, quality, spleen left rib 3.5cm, touch the pain. Liver distal flow sign (+). All joints are fusiform, with swelling and movement disorders, occipital and bilateral ribs, left and right ilium, the back can reach multiple bony nodules. Lower limbs slightly depressed edema.