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1 病例摘要及治疗经过 患者 男,46岁。主因发热咳嗽胸痛10天,于1994年11月14日入院。10天前受凉后出现发热,体温波动在37.8℃～38.5℃,轻度发冷无寒战,咳嗽咯白色粘痰,痰量中等,伴右上胸痛以吸气及咳嗽时为重,当地按肺炎静点青霉素治疗,3天后体温降至正常,但咳嗽等症改善不明显,胸片检查提示右肺上叶单发薄壁空洞伴有液平(图1,2见封3),考虑为肺囊肿继发感染,经用氨苄青霉素及灭滴灵联合静点,症状有所减轻,为进一步诊治转来我院。自发病以来无咯血、盗汗及黄绿色脓臭痰,体重无减轻。既往有慢性咳嗽咯痰史5年,冬春季节好发,每遇受凉感冒而诱发,抗炎治疗症状可缓解。1年前曾患肝炎,已治愈。近3个月来一般体力活动即感气短,胸透检查未发现异常。有吸烟史30年(20支/日)。
1 case summary and treatment of patients after male, 46 years old. The main cause of cough and chest pain for 10 days, in November 14, 1994 admission. 10 days ago after the onset of fever, body temperature fluctuations in the 37.8 ℃ ~ 38.5 ℃, mild chills no chills, cough slightly sticky phlegm, sputum volume moderate, with right upper chest pain to inhale and cough heavier, according to local pneumonia Point penicillin treatment, 3 days after the temperature dropped to normal, but no significant improvement in cough embolism, chest X-ray examination showed that the right upper lobe single thin-walled cavity associated with the level (see Figure 1, 2 see seal 3), considered as pulmonary cysts Secondary infection, the use of ampicillin and metronidazole joint static point, the symptoms have eased, transferred to our hospital for further diagnosis and treatment. Since the onset of hemoptysis, night sweats and yellow-green purulent sputum, no weight loss. Past history of chronic cough and phlegm 5 years, winter and spring are good hair, cold cats caught in each case induced by anti-inflammatory treatment of symptoms can be alleviated. A year ago had hepatitis, has been cured. In the past three months, the general physical activity that is shortness of breath, chest X-ray examination found no abnormalities. Smoking history of 30 years (20 / day).