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患者男,63岁。以时发咳喘13年,加重1个月入院。体检:T 37.6C、P100次/min。R20次/min、BP15/9kPa。发育正常,意识清楚,颈软,气管居中,甲状腺不大。桶状胸,双肺呼吸音略低,可闻及散在干湿哕音。心界无扩大,各瓣膜区未闻及病理性杂音,肝脾未触及;入院实验室检查:血、尿常规正常,肝、肾功能正常。心电图示:窦性心动过速。胸片示:慢支肺气肿并感染征。入院诊断为:慢性支气管炎、肺气肿并感染。给予青霉素、链霉素治疗1周后,咳嗽好转,但仍有胸闷,加服硫酸特布他林(博
Male patient, 63 years old. Time to cough and asthma 13 years, increased 1 month admission. Physical examination: T 37.6C, P100 times / min. R20 times / min, BP15 / 9kPa. Normal development, awareness, neck soft, tracheal center, thyroid is not big. Drum-shaped chest, breath sounds slightly lower lungs, can be heard and scattered wet and dry 哕 tone. No expansion of the heart, the valve area has not heard of pathological murmur, liver and spleen not touched; admission laboratory tests: normal blood, urine, liver and kidney function is normal. ECG shows: sinus tachycardia. Chest radiography: chronic bronchitis and signs of infection. Admission diagnosed as: chronic bronchitis, emphysema and infection. Give penicillin, streptomycin 1 week after treatment, the cough improved, but there is still chest tightness, plus serve terbutaline sulfate