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患者女,52岁,以发现下腹包块2个月,腹痛、排尿困难10d之主诉,于1989年6月3日收住外科。患者既往月经规律,经量较多。末次月经半年前。生产史:孕2产2。末次分娩20年前。 查体:T37.5℃,P87次/min,R19次/min,BP15/10kPa。贫血貌,营养欠佳,自动体位,查体合作。右侧腹股沟处可扪及黄豆大小的淋巴结3个。心肺(-),肝脾不大,腹软,于耻骨联合上可以扪及儿头大小的包块;压痛(+)。妇科检查:外阴(-),阴道(-),宫颈暴露不出,盆腔被包块占据,子宫大小扪不清。B超检查:子宫大小为9cm×9cm,子宫前下方可探及14cm×11cm大小之包块。提示:膀胱肿瘤。化验检查:
The female patient, 52 years old, was chief complaint of finding the lower abdominal mass for 2 months, abdominal pain and dysuria for 10 days and was admitted to the hospital on June 3, 1989. Past menstrual patients, by the amount of more. The last menstruation six months ago. Production history: 2 pregnant 2. The last childbirth 20 years ago. Physical examination: T37.5 ℃, P87 times / min, R19 times / min, BP15 / 10kPa. Anemia appearance, poor nutrition, automatic position, physical examination. Right inguinal palpable at the size of soybean-sized lymph nodes 3. Cardiopulmonary (-), hepatosplenomegaly, abdominal soft, palpable pubic symphysis size of the mass; tenderness (+). Gynecological examination: vulva (-), vagina (-), cervix can not be exposed, the pelvic mass is occupied, the size of the uterus palpable. B-ultrasound: uterine size is 9cm × 9cm, below the uterus can be explored and 14cm × 11cm size of the mass. Tip: bladder cancer. Laboratory tests: