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患者,男,50岁.因受凉后出现持续畏寒、发热,吞咽困难,伴右侧前胸、颈部、肩部胀痛5天,于1994年元月21日入院.无心悸、胸闷,无咳嗽、咯血.既往体健,无外伤史.查体:体温38.3℃,脉搏96次/分,咽部轻度充血,扁桃体无肿大;右侧颈部较左侧明显饱满,质软,摒气时更明显,未触及捻发音,未闻及肺泡呼吸音;右肺呼吸音粗糙、稍弱,无干湿性啰音;心腹正常;血象:Hb150g/L,WBC20.8×10~9/L,N88%,L12%.入院时胸片:右上肺见片状密影,下缘呈弧形,右颈部饱满,气管明显受压左移,建议CT.CT平扫示:右颈部见部分实变肺组织及少量含气肺组织(肺窗可见肺纹理),气管、食管受压左移明显,甲状腺受压前移.诊断:右颈部肺疝(大部分为实变肺组织).行抗炎(青霉素800万单位每日,静滴;氨苄青霉素5.0g/d,分2次静注)及对症处理.1周
Patient, male, 50 years old Persistent chills, fever and dysphagia after cold due to pain in the right chest, neck and shoulders for 5 days were admitted on January 21, 1994. No palpitations, chest tightness, No body loss, no history of trauma. Physical examination: body temperature 38.3 ℃, pulse 96 beats / min, mild pharyngeal hyperemia, tonsil no enlargement; right neck than the left is obviously full, soft, Exclamation when the more obvious, did not touch the twist pronunciation, no smell and alveolar respiratory sounds; right lung breath sounds rough, slightly weaker, no wet and dry rales; normal heart; blood: Hb150g / L, WBC20.8 × 10 ~ 9 / L, N88%, L12%. X-ray on admission: see sheet-like dense shadow on the right upper lung, curved arc on the lower edge, full right trachea and left trachea obviously under pressure. Department see part of the consolidation of lung tissue and a small amount of air-containing lung tissue (lung window visible lungs), trachea, esophageal left significantly pressure shift, thyroid compression forward.Diagnosis: right neck hernia (mostly solidified lung Organizations). Anti-inflammatory (penicillin 800 million units daily, intravenous infusion; ampicillin 5.0g / d, 2 intravenous) and symptomatic treatment .1 week