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患者黄某,女性,53岁,住院号269096。因阴道脱出物3小时余,于1993年1月21日急诊入院。 缘患者1982年因经量增多,发现子宫增大,B超示“子宫肌瘤”。一直未予治疗。1992年12月20日起白带增多,伴异臭味。1993年1月1日开始觉小便不顺畅,无尿频、尿急、尿病等不适。1月19日无明显诱因突然畏寒、发热,达39℃,无流涕咳嗽、腹痛、腹泻等不适。今晨8时许下腹隐痛不适,伴尿频,无尿痛,觉便意感,排大便历时10分钟,排便后觉有肿物自阴道脱出,如儿头大,表面有鲜血流出,量多,并晕厥数分钟,即急诊抬入院。 患者月经史457/30,末次月经1992年12月22日,平时用纸2~+包伴血块,无痛经史。G_4P_3,末次产1969年。 体查:T38.5℃,P85次/分,R20次/分,BP12/7kPa,面色苍白,神清合作,妇检:外阴发育良好,阴道口见一肿物约15×12×10cm,表面凹凸不平,右侧有一2mm破溃口,活动性出血,肿物表面见多量粘稠液体,味恶臭、蒂粗约3×3cm,源于宫腔,于阴道口扪及宫颈外口,可容一指尖,子宫如孕2~+月大,质硬不平,可动,双附件
Patient Huang, female, 53 years old, hospital number 269096. Due to vaginal discharge more than 3 hours, January 21, 1993 emergency admission. Edge patients in 1982 due to increased volume and found that the uterus increased, B ultrasound showed “uterine fibroids.” Has not been treated. December 20, 1992 leucorrhea increased, with different odor. January 1, 1993 began to feel urine is not smooth, no urinary frequency, urgency, diabetes and other discomfort. January 19 no obvious incentive suddenly chills, fever, up to 39 ℃, no runny nose cough, abdominal pain, diarrhea and other discomfort. This morning at 8 am under abdominal pain and discomfort, with frequent urination, no dysuria, feel the meaning, row stool lasted 10 minutes after defecation felt a tumor from the vaginal prolapse, such as a large head, the surface of blood outflow, the amount of more and Syncope for a few minutes, that is, emergency hospital. Menstrual history of patients 457/30, the last menstrual December 22, 1992, usually with paper 2 ~ + package with blood clots, painless history. G_4P_3, the last production in 1969. Physical examination: T38.5 ℃, P85 beats / min, R20 beats / min, BP12 / 7kPa, pale, clear cooperation, women’s examination: vulva developed well, vaginal mouth see a tumor about 15 × 12 × 10cm, the surface Uneven, the right side of a 2mm rupture mouth, active bleeding, see a large number of viscous liquid tumor surface, stench, pedunculated about 3 × 3cm, derived from the uterine cavity, palpable at the vaginal opening cervix and can accommodate a Fingertips, uterus, such as pregnancy 2 ~ + month, hard, movable, double attachment