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患者,女性,48岁。因腹部肿物1年于1994年6月15日就诊。一年前无意中发现右下腹有一手拳大小肿物,活动、质硬、无触痛。5个月后自觉腹部肿物生长迅速。仅2～3个月腹部增大至足月妊娠大小。伴有腹部胀痛感,行走困难,双下肢浮肿。近3个月来不能平卧,呼吸困难。查体:T36.4℃,P116次/分,R26次/分,BP17/12kPa。恶病质,被动半卧位,皮肤无黄染,浅表淋巴结未触及肿大,贫血貌,胸式呼吸,双肺呼吸动度受限,呼吸音清晰,心率116次/分,律齐,膈肌上升,腹部高度膨隆,可见明显腹壁静脉曲张,整个盆腹腔被巨大肿物充填,肿物上极达剑突下,下极至耻骨联合,腹围最大周径119cm,肿物为实性感,腹水征(+),双下肢浮肿(+++)。实验室检查:白细胞12.6×10~9/L,中性0.76,血红蛋白78g/L,
Patient, female, 48 years old. He was diagnosed on June 15, 1994 due to abdominal mass. A year ago, I accidentally found a fist mass in the right lower abdomen, which was active, hard, and tender. After 5 months, the abdominal mass was found to grow rapidly. Only 2 to 3 months of abdominal enlargement to full-term pregnancy size. Accompanied by abdominal pain, difficulty walking and edema of both lower extremities. In the past 3 months, I cannot lie flat and I have trouble breathing. Physical examination: T36.4°C, P116 beats/min, R26 beats/min, BP17/12kPa. Cachexia, passive semi-recumbent, skin without jaundice, superficial lymph nodes without swelling, anemia appearance, chest breathing, lungs with limited breathing movement, breath sounds clear, heart rate 116 beats/min, regularity, diaphragmatic muscle rise The height of the abdomen is bulging. Obvious abdominal varicose veins are seen. The entire pelvic cavity is filled with huge tumors. The upper pole of the tumor is under the xiphoid process, and the lower pole is connected to the pubic symphysis. The maximum circumference of the abdominal circumference is 119cm. The tumor is truly sexy and has ascites sign. (+), lower extremity edema (+++). Laboratory examination: WBC 12.6×10~9/L, neutral 0.76, hemoglobin 78g/L,