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病例摘要: ,男,57岁,退休干部。2014年9月就诊。 患者吸烟40年,每日2包。平素痰多,诊前1个月因搬运重物后开始自觉左侧胸痛、痰多1个月,自认为是拉伤,自服芬必得3天。胸痛不缓解,到当地诊所静脉滴注青霉素1停药。自觉胸痛一度略减轻,咯痰略减少,但近日来无明显诱因胸痛再次加重,咳嗽、深呼吸明显,夜间痛甚;胸闷气短,咯痰量多,黄色黏稠痰,乏力纳差便溏。 查体:T36.2℃,P84次/分,R20次/分,BP120/80mmHg。双肺呼吸,肺可闻及湿啰音。心率84次/分,律齐,肝脾未及,双下肢无浮肿。舌质暗红,苔白厚腻,脉滑。 辅助检查:血常规:WBC8.2×10 9 /L,N66%。胸片:肺大面积团块影。胸部CT:双肺多处片状阴影,肺近胸膜处可见直径约5cm团块影,有分叶,边界有细长毛刺。纤维支气管镜取支气管组织病理活检结果:可见癌细胞,免疫组化结果为中-低分化腺癌。 答题要求:1.根据上述病例摘要,在答题卡上完成书面辨证论治。 2.鉴别诊断:请与结核球相鉴别。
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A.
Do not buy it.
B.
The easiest is to steam it.
C.
This is how you can do it.
D.
It just requires a little knowledge.
E.
The fish will go bad within hours.
F.
When buying fish,you should first smell it.
G.
The fats in fish are thought to help pr heart disease.
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