病史摘要 男,3岁。因咳嗽20余天伴气喘、浮肿7天入院。病初伴发热3天,体温38.5℃左右,给以口服“消炎药及退热剂”治疗后体温降至正常。7天前咳嗽加重,伴气喘,面部及两下肢浮肿,在当地医院给以抗结核治疗7天及胸腔穿刺治疗2次,共抽出血性胸腔积液约1000ml,病情无好转,气喘进一步加重,并出现尿量少,黑便等,转我院。患儿既往健康,无结核接触史,出生后已接种卡介苗,家族中无遗传性疾病。体检:T 36.5℃,P150次/分,R 68次/分,WT 14kg。神清,消瘦,表情痛苦,时有呻吟,面色苍白,口周发绀,面部及两下肢浮肿。浅表淋巴结无肿大。颈软,气管向右侧移位。左侧胸廓饱满,肋间隙增宽,叩诊实音,听诊呼吸音消失,右肺呼吸音 Medical History Abstract Male, 3 years old. Cough for more than 20 days with asthma, edema, 7 days admission. Early fever with fever for 3 days, body temperature 38.5 °C or so, given oral “anti-inflammatory drugs and antipyretics” after treatment to normal body temperature. 7 days before the cough increased, with asthma, edema of the face and both lower extremities, in the local hospital to give anti-tuberculosis treatment for 7 days and thoracentesis 2 times, a total of hemorrhagic pleural effusion about 1000ml, the condition did not improve, asthma further aggravated, and There was less urine, black stools, etc., transferred to our hospital. The children were previously healthy, had no history of tuberculosis exposure, had been vaccinated with BCG after birth, and had no hereditary diseases in the family. Physical examination: T 36.5°C, P150 beats/min, R 68 beats/min, WT 14kg. Shen Qing, weight loss, painful expression, when there is phlegm, pale, perioral cyanosis, facial and edema of both lower extremities. Superficial lymph nodes are not swollen. Soft neck, tracheal shift to the right. Left chest full, widened intercostal space, percussion sound, auscultation of breath sounds, right lung breath sounds