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患者,女,47岁,因腹胀,腹痛一月,加重一周,于1993.1.4.收住入院。患者于入院前一月出现左下腹胀痛不适,先后在外院按炎性包块治疗,无显效。曾在1992.5妇科普查时发现左侧卵巢囊肿,约鸡蛋大小,因无症状未介意。月经尚规律,Lmp:93.1.4孕2产2存2,末次分娩16年前。查体;T36℃,P80次/分,R20次/分,BP15/10KPa。腹部膨隆,肝脾未触及,下腹部可触及一包块,质硬,压痛明显,界线不清,不活动。妇查:外阴、阴道宫颈无异常。后穹窿处可触及硬结。盆腔可触及一25×20×18cm~3的包块,与子宫连成一体。经抗炎,抗痨治疗无效,病情日趋加重,肿块进行性增大,出现持续低热。经全科讨论,首先考虑:①卵巢恶性肿瘤;②盆腔脓肿;③结核待排。决定立
Patient, female, 47 years old, due to abdominal distension, abdominal pain in January, increased one week, in 1993.1.4. Admitted to hospital. Patients with left lower quadrant pain and discomfort appeared in January before admission, and they were cured by inflammatory mass in the outer hospital one after another. Gynecological census in 1992.5 was found on the left ovarian cysts, about the size of the egg, asymptomatic did not mind. Menstruation is still the law, Lmp: 93.1.4 2 pregnant with 2 deposit 2, the last delivery 16 years ago. Examination; T36 ℃, P80 beats / min, R20 beats / min, BP15 / 10KPa. Abdominal bulge, liver and spleen not touched, lower abdomen can reach a mass, hard, tenderness, the boundary is unclear, inactive. Women check: vulva, vaginal cervix without exception. Posterior fornix can reach induration. Pelvic access to a 25 × 20 × 18cm ~ 3 mass, and the uterus into one. After anti-inflammatory, anti-tuberculosis treatment ineffective, the condition is aggravating, mass progressively increased, there continued low fever. After general discussion, first consider: ① ovarian cancer; ② pelvic abscess; ③ tuberculosis to be discharged. Decided to stand