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患者郭某某,男性,20岁,学生,住院号241598。以进行性胸闷、气短1月之主诉入院。入院前曾抗结核治疗2周,抽出血性胸水6000ml,症状不减轻,收住院治疗。既往体健,无石棉接触史。查体:T37℃,浅表淋巴结不肿大,气管左移,右侧胸廓饱满,语颤减弱,叩诊呈实音,第二前肋水平以下呼吸音消失。左肺(-)。心界左移,心尖搏动位于左腋前线。肝、脾未触及,无杵状指、趾。X线胸片,右侧胸腔大量积液。血常规:Hb9.5%,WBC7040,中性粒细胞73%,ESR:50mm/hr。住院经过:入院后抽胸水检查,胸水为深红色血性,粘稠,难以抽出。化验:蛋白3.5%,氯化物590mg%,糖33.1mg%,细胞数51个/mm~3。细胞学检查:可见少数退变的可疑瘤细胞。两次胸膜活检未见肿瘤组织。X线断层拍片:右主支气管向左移位,气管分叉角缩小,未见狭窄和中断现象。胸部B型超声检
Patient Guo Moumou, male, 20 years old, student, hospital number 241598. The chief complaint of progressive chest tightness and shortness of breath was admitted to hospital in January. Before admission, he had antituberculosis treatment for 2 weeks and he received 6,000ml of hemorrhagic pleural effusion. His symptoms did not decrease and he was admitted to hospital for treatment. Past health, history of non-asbestos exposure. Physical examination: At T37°C, the superficial lymph nodes were not swollen, the trachea was shifted to the left, the right thoracic trunk was full, the lingual trespass was weakened, the percussion was a real sound, and the breath sounds below the second front rib disappeared. Left lung (-). The left side of the heart is moving, and the apex beat is located in the left front line. The liver and spleen are not touched, and there are no callous fingers or toes. X-ray chest, a large amount of fluid in the right chest. Blood routine: Hb9.5%, WBC7040, neutrophils 73%, ESR: 50mm/hr. After hospitalization: After pleural effusion was taken after admission, the pleural effusion was dark red bloody, sticky and hard to withdraw. Laboratory tests: protein 3.5%, chloride 590mg%, sugar 33.1mg%, cell number 51/mm~3. Cytological examination: A few degenerate suspect tumor cells are seen. No pleural biopsy showed tumor tissue. X-ray tomography film: The right main bronchus was shifted to the left, and the tracheal bifurcation angle was reduced. There was no stenosis or interruption. Chest B type ultrasound examination