论文部分内容阅读
病史摘要患者男,80岁。因反复上腹部疼痛,返酸伴有前胸部紧束感10年。于1988年3月在江苏某医院诊断为食管裂孔疝及返流性食道炎。按常规剂量服用西咪(口替)丁及胃复安后症状明显减轻,病情稳定。一年后自行将西咪(口替)丁改为雷尼(口替)丁,每天三次每次300毫克,连服两年,以后出现头晕、耳鸣、持续性上腹部疼痛,伴有呕吐及进行性吞咽困难,呕吐大量粘液及胃内容物。再次去该医院复查;确诊食管裂孔疝、返流性胃炎贲门癌。查体:消瘦,神萎,面色苍黄虚胖,皮肤粘膜无出血,全身浅淋巴未触及。轻度桶状胸,胸壁及胸骨
Summary of patient history Male, 80 years old. Because of repeated pain in the upper abdomen, back to the acid accompanied by chest tightness sense 10 years. In March 1988 in Jiangsu Province, a hospital diagnosed as hiatal hernia and reflux esophagitis. According to the conventional dose of cimetidine (oral) Ding and metoclopramide significantly reduced symptoms, stable condition. A year later, she changed her name to Sini (oral replacement) Ding 300 mg three times a day for two years even after she developed dizziness, tinnitus, persistent upper abdominal pain accompanied by vomiting and Progressive swallowing difficulties, vomiting a lot of mucus and stomach contents. Go to the hospital again review; confirmed esophageal hiatal hernia, reflux gastritis cardia cancer. Physical examination: weight loss, Shen Wei, pale pale complexion, skin and mucous membrane without bleeding, systemic lymphatic vessels did not touch. Mild tub-shaped chest, chest wall and sternum