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双肺弥漫性磨玻璃影并纵隔气肿
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- Author:
- No author available
- Journal Title:
- Chinese Journal of Tuberculosis and Respiratory Diseases
- Issue:
- 7
- DOI:
- 10.3760/cma.j.issn.1001-0939.2015.07.023
- Key Word:
- No keyword available
Abstract： 患者男,44岁,主因“间断腹痛腹泻13年,加重伴发热1个月”入院.患者13年前无诱因出现腹痛、腹泻.肠镜示回肠末端、结肠多发纵行溃疡,病理可见非干酪性上皮样肉芽肿,考虑“克罗恩病”,给予柳氮磺吡啶口服后症状好转.此后腹痛腹泻每1～2年发作一次,5个月前腹痛、腹泻再次加重,给予甲泼尼龙40 mg/d和硫唑嘌呤75 mg/d口服,腹痛腹泻好转,后激素渐减量至16 mg.1个月前腹痛再次加重,伴发热,体温最高39.4℃,无咳嗽、气短.给予左氧氟沙星静脉点滴,效果欠佳,为求进一步诊治入院.既往吸烟指数450年支.体检:体温38℃,双下肺可闻及湿啰音.腹软,无压痛.X线胸片示双下肺斑片状高密度影(图1).入院初步诊断:克罗恩病,活动期;肺炎.
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