1病例报告患者男,18岁。因胸闷、胸痛、呼吸困难伴咳嗽、咳痰20天就诊。查体:体温37.2℃,呼吸30次/min,心率127/min,血压133/81mmHg。双上肺呼吸音粗,双下肺呼吸音消失,可闻及摩擦音;心律齐。上腹部剑突下压痛,无反跳痛、肌紧张,于右肋下约6cm处触及肝下界,质硬(如触鼻尖),脾未触及。实验室检 1 case report Patient male, 18 years old. Due to chest tightness, chest pain, difficulty breathing with cough, expectoration 20 days treatment. Examination: body temperature 37.2 ℃, breathing 30 beats / min, heart rate 127 / min, blood pressure 133 / 81mmHg. Double lung breath sounds thick, double lung breath sounds disappear, can be heard and fricative; Upper abdomen Xiphoid tenderness, no rebound tenderness, muscle tension, about 6cm at the right rib touching the lower liver, hard (such as tip of the nose), spleen not touched. Laboratory test