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患者,男,53岁,住院号21307。因胸闷乏力,钠差、腹胀1个月伴神志不清1天,于1988年10月2日入院。13年前患肝炎病,肝硬化病史10年。11个月前出现右侧胸部不适,渐感胸闷、气急。在外院以“结核性胸膜炎”给予“丁胺卡那霉素、链霉素”等治疗,并于1周内抽胸水2次,总量达3300ml。胸闷改善,但乏力加重伴腹胀。此次抽胸水出现昏迷意识障碍。转我院,检查:神志不清,浅昏迷,轻度躁动。呼吸平,无肝臭。可见蜘蛛痣3枚。巩膜微黄。气管居中。右中、下肺叩诊浊音。呼吸音明显减低,语颤音低。左肺和心脏无异常。腹部中度膨隆,肝上界第6肋间肝脾肋下未扪及。移动性浊音明显,腹围86cm,两
Patient, male, 53 years old, hospital number 21307. Because of chest fatigue, poor sodium, abdominal distension 1 month with delirium 1 day, on October 2, 1988 admission. 13 years ago suffering from hepatitis, cirrhosis history for 10 years. 11 months ago appeared on the right chest discomfort, gradually feeling chest tightness, shortness of breath. Outside the hospital to “tuberculous pleurisy” given “amikacin, streptomycin” and other treatment, and within 1 week, twice a year, pleural effusion, the total amount of 3300ml. Chest tightness improved, but aggravated with abdominal distension. The chest pumping water unconsciousness unconsciousness. Transfer to our hospital, check: unconsciousness, shallow coma, mild agitation. Breathing flat, no liver odor. Visible spider 3. Sclera slightly yellow. Tracheal center. Right middle and lower lung percussion dullness. Breathe was significantly reduced, language vibrato low. Left lung and heart no abnormalities. Moderate bulging abdomen, the upper boundary of the liver on the 6th intercostal liver and spleen ribs palpable. Obvious mobility dullness, abdominal circumference 86cm, two