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患男,62岁,以反复咳喘30年神志不清1h急诊入院。30年前原因不明咳喘,以后因寒冷而加重,上楼心悸呼吸困难。1h前大便后走到床边突然神志不清,双手握拳、呼之不应来院就诊。既往患肾盂肾炎期间血压高。入院检查T36℃,P100 次/min,R24 次/min,BP16/8kPa,神志恍惚,形体消瘦,慢性病容,查体欠合作,瞳孔等大等圆,对光反应存在,口唇轻度发绀,颈静脉怒张,桶状胸,呼吸音低,心界缩小,心律齐,心音低,P_2>A_2,腹平软,肝脾未及,
Male, 62 years old, with cough and asthma 30h unconscious 1h emergency admission. 30 years ago, the cause unknown cough, later aggravated by the cold, upstairs palpitations breathing difficulties. 1h before going to the bed after the stool suddenly unconscious, hands fist, call should not be hospitalized. Previous high blood pressure during pyelonephritis. Admission examination T36 ℃, P100 times / min, R24 times / min, BP16 / 8kPa, trance, body weight loss, chronic disease, physical examination owe cooperation, pupil and other large circle, the presence of light reaction, lips mild cyanosis, neck Venous anger, barrel chest, low breath sounds, reduced heart, heart Qi, low heart sound, P_2> A_2, abdominal soft, liver and spleen not,