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患者，男性，78岁，因右下肢疼痛2天收住普外科。5年前因双下肢动脉硬化性闭塞症行肢截肢术。既往慢性支气管炎30年，高血压病15年，糖尿病20年，冠心病10年，陈旧性心肌梗死史5年。入院诊断双下肢动脉硬化性闭塞症。入院后行右下肢截肢术。术后第二天起出现气急、胸闷，并进行性加重，伴大汗，端坐呼吸，阵阵咳嗽，咳泡沫样痰，无发热。体检：半卧位，T37℃，HR172次／分，BP170／100mmHg，面罩吸氧，氧流量10L／min，RR35次／分，指脉搏氧饱和度93％，大汗淋漓，听诊双肺布满哮鸣音和湿啰音。提示：WBC10．0×10 9 ／L、PLT137×10 9 ／L、Hb90g／L、血钾3．7mmol／L、钠136mmol／L、氯105mmol／L、钙2．0mmol／L、血糖7．94mmol／L（143mg／dl）、血肌酐62μmol／L（0．7mg／dl）、血尿素氮2．5mmol／L（7mg／dl），PaO 2 60mmHg，PaCO 2 50mmHg，BE－4．5mmol／L，CK380U／L、CK－MB13U／L，肌钙蛋白Ⅰ阴性。胸片示：心影向扩大，肺增大，双肺弥漫渗出伴中等量胸腔积液。心脏B超：扩大，室壁节段运动异常，心尖运动明显减弱，收缩功能减退，射血分数35％。心电图：快室率房颤，V1～V3导联QRS波群呈QS型，V3导联呈qR型。提问：针对目前病情变化应做什么诊断？（）A.
慢性支气管炎急性发作
B.
急性呼吸衰竭
C.
急性心力衰竭
D.
双侧胸腔积液
E.
急性心肌梗死
F.
急性肺栓塞
G.
重症肺炎
H.
心源性休克
I.
肺
J.
支气管哮喘急性发作
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