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[ 會員# ] 黃先生

咳血

醫生你好~

我今年28歲,男姓己婚,沒有吸煙習慣,今年3月28日突然咳血入院,咳血量也很多,大約十幾口鮮血,醫生照x-ray後,話係肺炎,但沒有發燒,留了三日痰化驗,沒有特別出院了,開了抗生素(augmentin(generic substitute)tablet 375MG)、止血丸(tranexamic acid capsule 250mg)和黑色的咳藥水。之後我到了私家照了ct scan,出了報告,之後到醫院覆診,醫生說原本肺炎右邊有少少花,但ct出來,右邊不大問題,但左邊肺有疤痕,可能是以前肺炎留下,但我印象中我以往沒有肺炎,但醫生說5月尾再照ct。以下是ct 報告建議﹕
“There are small and tiny non-calcified nodules in the apico-posterior segment of the left upper and lower lobes. These are associated with minor subsegmental atelectasis, pleural tethering, ground-glass opacification, mild focal bronchiectasis, and bronchial wall thickening. The overall appearances are non-specific, and may represent areas of granuloma formation and scarring related to previous infection or inflammation. However, some of these sites are suggestive of an active infection / inflammation including TB. Correlation with inflammatory parameters may be warranted. A neoplastic lesion or metastatic deposit is unlikely but not completely excluded. Follow up imaging may be warranted. The rest of the lungs are clear. There are no enlarged lymph nodes at the thoracic level. The pleural and pericardial spaces are clear.”

影象顯示的其中一句
The small nodules measure up to 11 mm in maximum dimensions. The tiny nodules are 2 to 3 mm in diameter. They are centrilobular, some of which demonstrate a tree-in-bud configuration.

現在沒有咳血,但還有咳和胸痛,而且肩背有痛,左邊腹部前邊及左邊腰部每天間中隱痛,大便稀爛而且伴有黑色水,早上及大便後更明顯,而且每次食飯後有少少食物回流。早上有時會有鼻涕帶少許血絲,而且間中會有喉嚨痛。現在我直不知現在如何做,政府的醫生又不太理會我,現在沒有藥食,又有以上問題。
1. 我的咳血是什麼原因呢,嚴重嗎,我會不會是癌症呢?
2. 我現在可以怎樣做呢? 需否再做其他檢查呢?
3. 我的腹痛上年已經有了,但看了醫生好了點,但平常間中有痛,現在又有以上問題,是什麼原因呢,我又可以怎樣做呢?

非常擔心,希望醫生能幫忙,謝謝醫生。
黃生您好.
不用擔心, 我認為你沒有癌病.反而擔心肺結核及支氣管擴張. 你需要:

1. 專科醫生重新小心評估你所有最近的CT及X光片
2. 仔細臨床檢查
3. 或需作氣管鏡(bronchoscopy)檢查

建議您找呼吸系統專科醫生跟進.

祝早日康復, 身體健康.
以上資料只供參考,不能作診症用途,
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診,切勿延誤治療。
若資料有所漏誤,本網及相關資料提供者恕不負責。



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