论文部分内容阅读
病史摘要 住院号234630,农妇,52岁,于2年前因子宫肌瘤而行全子宫切除术,术后情况一直良好。2月前出现下腹胀而就诊时被发现盆腔内有8～9cm直径的囊块,即在当地医院行剖腹探查,术中见腹腔内有大量粘液和乳头状肿瘤,质脆,取少量组织作活组织检查,病理报告为“腹膜粘液瘤来源于卵巢粘液性囊腺瘤破裂。”术中未行肿瘤切除,术后也未予化疗,近1~+月来因胃纳差、消瘦日益明显,并且腹部迅速胀大伴双下肢浮肿和吸呼困难,于1982年7月20日转来本院。 体格检查:体温37.9℃,面色苍白、消瘦、气急不能平卧,心肺(-),腹大,腹壁静脉可见,有明显转移性浊音,肠鸣音存在,肝脾未能扪清,在下腹部有两处手术疤痕,二下肢凹陷性水肿。妇科检查:阴道顶愈合佳,下腹上方可扪及一足月妊娠大小的块物,质中等,边缘不清。 实验室检查:血常规:红细胞360万/mm~3,白细胞6000/mm~3。肝肾功能:锌浊度18.5单位,血清谷丙转氨酶<40单位。尿素氮13mg％,肌酐1.8mg％。尿常规无特殊。血钾3.7mEq/L,血钠140mEq/L,血氯94mEq/L。
Medical History Abstract Hospitalization No. 234630, peasant woman, 52 years old, had undergone hysterectomy 2 years ago. When abdominal bloating occurred 2 months ago, he was found to have 8 to 9 cm in diameter cysts in the pelvis. This was a laparotomy at a local hospital. During surgery, there was a large number of mucinous and papillary tumors in the abdominal cavity. Biopsy, pathology report as “peritoneal myxoma originated from rupture of ovarian mucinous cystadenoma.” No tumor resection was performed during the operation, no chemotherapy was performed after the operation, and the difference in appetite and wasting became more apparent in the past 1 to + months. The abdomen quickly swollen with difficulty in edema and inhalation of both lower extremities and was transferred to our hospital on July 20, 1982. Physical examination: body temperature 37.9 °C, pale, weight loss, shortness of breath can not be supine, heart and lung (-), large abdomen, abdominal wall vein visible, significant metastatic dullness, bowel sounds exist, liver and spleen failed to clear, in the lower abdomen Two surgical scars, two edema of lower limb edema. Gynecological examination: good vaginal top healing, upper abdomen can be paralyzed and the size of a full-term pregnancy block, medium quality, unclear edge. Laboratory tests: Blood routine: Red blood cells 3.6 million/mm~3, white blood cells 6000/mm~3. Liver and kidney function: 18.5 units of zinc turbidity and <40 units of serum alanine aminotransferase. Urea nitrogen 13mg%, creatinine 1.8mg%. No special urine routine. Blood potassium 3.7mEq/L, serum sodium 140mEq/L, blood chlorine 94mEq/L.