患者，男，４９岁。因反复咳嗽、咳痰１个月，胸闷、气促半个月，呕吐咖啡色胃内容物２日入院。发病后曾在当地医院诊为“肺部感染、胸腔积液”先予抗生素治疗，其后又予抗结核、强心、利尿等治疗，病情未见好转。体检：体温３６．２℃，脉搏 ８０次／分，呼吸 ２３次／分，血 Patient, male, 49 years old. Due to repeated coughing, sputum for 1 month, chest tightness, shortness of breath for half a month, vomiting, brown stomach contents were admitted on the 2nd. After the onset of a local hospital diagnosed as “lung infection, pleural effusion,” the first antibiotic treatment, followed by anti-TB, cardiac, diuretic and other treatment, the condition did not improve. Physical examination: body temperature 36.2 ℃, pulse 80 beats / min, breathing 23 beats / min, blood