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患者,24岁,孕1产0。因妊娠足月第一胎,右上腹憋胀伴疼痛,不能平卧15小时,于1995年1月12日住院。末次月经1994年4月18日。孕早、中期经过顺利。妊娠30周后经常腹部不适、隐痛、不放射,以右侧为重。1994年12月29日腹部B超检查:右肾盂积水约20cm×10.5cm大小。既往身体健康,无肾脏病史。查体:呈半卧位。心肺(一)。右上腹及中腹部高度膨隆,右侧腹部隆起,囊性感、不活动、张力不大、与子宫界限清楚,右肾区叩击痛。宫高30cm,胎位LOA,胎心140次/分,无宫缩。肛诊:宫口未开,胎膜未破。腹部B超检查:胎儿双顶径9.3cm,羊水深5.0cm,胎心搏动好,胎盘功能Ⅱ级,在子宫右上方探及30cm×30cm×18cm液性包块,与子宫,肝
Patient, 24 years old, pregnant 1 producing 0. Due to first trimester of pregnancy, right upper quadrant biliary swelling with pain, can not supine 15 hours, January 12, 1995 hospitalization. The last menstruation April 18, 1994. Early pregnancy, mid-passed smoothly. After 30 weeks of pregnancy often abdominal discomfort, pain, no radiation, to the right as the most important. December 29, 1994 Abdominal B-ultrasound: right renal hydronephrosis about 20cm × 10.5cm size. Past health, no history of kidney disease. Physical examination: was semi-recumbent position. Heart and lung (a). The right upper abdomen and mid-abdomen bulge height, the right abdomen bulge, cystic sexy, not active, tension is not clear, clear boundaries with the uterus, right kidney percussion pain. Palace height 30cm, fetal position LOA, fetal heart rate 140 beats / min, no contractions. Rectal examination: cervix is not open, fetal membranes are not broken. Abdominal B-ultrasound: fetus biparietal diameter 9.3cm, amniotic fluid depth 5.0cm, good fetal heart beat, placental function grade Ⅱ, in the upper right uterus exploration and 30cm × 30cm × 18cm liquid mass, and the uterus, liver