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患者,男,19岁。右耳反复流脓多年,半月前流脓增多,味臭,近3天来流脓减少,头痛伴发热,耳后及颞部肿胀并迅速波及右侧头部。体检:T38.2℃,P88次/分,R23次/分,BP16.8/10.7kPa。右侧头皮肿胀,其范围内起颅中线,前至眉弓,后至枕外粗隆与耳后相连;触之质软,有明显波动感。右侧额部及上、下眼睑肿胀,右外耳道后壁明显隆起有脓溢出,奇臭,鼓膜标志不清。实验室检查:Hb90g/L,RBC3.2×10~(12)/L,WBC189×10~9/L,NO.81,L0.09。右乳突X线摄片示:乳突浓密,蜂房结构消失,上鼓室、鼓窦明显扩大,边缘清楚,可见硬化圈;窦内见散在斑片状、结节状不规则模糊致密影。头颅正侧位X
Patient, male, 19 years old. Repeated empyema in the right ear for many years, a half months ago, increased pus, odor, reduce pus in the past 3 days, headache with fever, ear and temporal swelling and quickly spread to the right side of the head. Physical examination: T38.2 ℃, P88 beats / min, R23 beats / min, BP16.8 / 10.7kPa. Right scalp swelling, the scope of the cranial line, before the eyebrow bow, after the occipital outer tuberosity connected with the ear; touch the soft, there is a clear sense of volatility. Right forehead and upper and lower eyelid swelling, right posterior wall of the posterior wall of the ear obviously swelling overflowing, stinky, eardrum signs unclear. Laboratory tests: Hb90g / L, RBC3.2 × 10 ~ (12) / L, WBC189 × 10 ~ 9 / L, NO.81, L0.09. Right mastoid X-ray showed: dense papillae, the disappearance of the hive structure, the tympanic cavity, the drum sinus significantly expanded, the edge clear, visible hardened ring; sinus see scattered patchy, nodular irregular fuzzy dense shadow. Head is lateral X.