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临床讨论这位病人表现为一个免疫功能受抑制的、有急性间发病的病人常会见到的临床问题。本例有紫绀、呼吸急促以及胸部临床检查无异常而 X 线检查有广泛阴影等表现所组成的特征性症状群。这种情况最可能提示为卡氏肺囊虫性肺炎。细菌性肺炎虽亦有可能,但会有更多的局灶性体征和排痰性咳嗽,以及广谱抗生素对其应有一定疗效。马利兰疗法引起肺纤维化和肺功能损害并非罕见,但不会表现得如此急剧。肺栓塞虽可表现为干咳和呼吸困难,即使病人过去作过盆腔手术,但就病人的情况而论,很可能不像肺栓塞,而且心电图的表现是非特异性的。
Clinical Discussion This patient is characterized by a clinical problem that is often seen in patients with impaired immune function and acute onset of disease. This example has cyanotic, shortness of breath and chest clinical examination without abnormalities and X-ray examination has a wide range of features such as the performance of the shadow group. The most likely suggestion for this condition is Pneumocystis carinii pneumonia. Although bacterial pneumonia is also possible, there will be more focal signs and expectoration of the cough, and broad-spectrum antibiotics should have some effect on it. It is not unusual for Mallary blue to cause lung fibrosis and impaired pulmonary function, but it does not appear to be so dramatic. Although pulmonary embolism can manifest as a dry cough and dyspnea, even though the patient has undergone pelvic surgery in the past, it is likely that unlike the pulmonary embolism in the context of the patient, the performance of the ECG is nonspecific.