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粟粒性结核是成人急性呼吸窘迫综合征(ARDS)少见的病因。本文报告了2例并复习了有关文献。例1 女性32岁,病人发热8天,干咳4天并有极度呼吸困难,无结核接触史。体检:体温40℃,脉搏130次/分,血压140/80mmHg,呼吸40次/分。胸部X线呈现严重肺水肿。动脉血气改变:pH7.53,PaO_241mmHg,PaCO_233mmHg,碱剩余+6,肺动脉压10mmHg,诊断为非心原性肺水肿。吸纯O_2后,PaO_2只有53mmHg,改用呼吸机后,PaO_2上升。经支气管肺活检证实有干酪性肉芽肿,并培养出结核杆菌。
Miliary tuberculosis is a rare cause of adult acute respiratory distress syndrome (ARDS). This article reports 2 cases and reviews the literature. Example 1 Female 32 years old, patient fever for 8 days, dry cough for 4 days with extreme respiratory distress and no history of TB exposure. Physical examination: body temperature 40 ℃, pulse 130 beats / min, blood pressure 140 / 80mmHg, breathing 40 beats / min. Chest X-ray showed severe pulmonary edema. Arterial blood gas changes: pH7.53, PaO_241mmHg, PaCO_233mmHg, alkaline residue +6, pulmonary arterial pressure 10mmHg, diagnosis of non-cardiogenic pulmonary edema. After inhaling pure O 2, PaO 2 only had 53 mmHg, and after using ventilator, PaO 2 increased. Bronchopulmonary biopsy confirmed caseous granuloma and cultured Mycobacterium tuberculosis.