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患者 女,59岁。因慢性咳、痰、喘二十余年,加重5天入院,查体:T36.5℃,P90次/分,R20次/分,BP14/10kPa(105/75mmHg)。一般状态欠佳,慢性病容,体形消瘦。颈静脉怒张,胸廓呈桶状,肋间隙增宽,肺肝界位于右侧锁骨中线节七肋间,双肺可闻及干湿啰音。心前搏动于剑突下明显,心脏各瓣膜听诊区未闻及杂音,腹平坦,肝下缘位于右肋下四指,缘锐,质中,有触痛。双下肢无水肿,神经系统未见异常。辅助检查,血常规:WBC
Female patient, 59 years old. Due to chronic cough, phlegm, and wheezing for more than 20 years, admitted to hospital for 5 days, physical examination: T36.5 ℃, P90 beats / min, R20 beats / min, BP14 / 10kPa (105 / 75mmHg). The general state of poor, chronic disease, body weight loss. Jugular vein engorgement, thorax was barrel-like, intercostals space widening, lung and liver boundary is located in the right subclavian midline section of the seven intercostal space, the lungs can be heard and wet and dry rales. Before the beating heart in the xiphoid significantly, the heart of the valve auscultation area did not smell and noise, flat belly, the lower edge of the liver is located in the right rib four fingers, edge sharp, quality, tenderness. No lower extremity edema, no abnormalities in the nervous system. Auxiliary examination, blood: WBC