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患者,男,32岁,住院号14762。一年前右大腿上外侧有一鸡蛋大小无痛包块,关节活动正常,后渐增大,时有局部压痛.近4个月来包块增长速度较快,常低热,肿块压痛明显,关节功能存在,步态尚稳,于1986年1月30日入院。体检:T38℃,P88次,BP120/80.胸廓对称,双肺中下部可闻及散在湿罗音.心脏未听及病理性杂音.腹平软,肝牌未扪及。两侧腹股沟可扪及数个直径约1 cm 大小淋巴结,活动度好。右股骨上段外侧软组织见14.5×12×5.3cm~3巨大肿块,中间隆凸,表面呈紫红色,光滑,压之有波动感,无血管搏动。基底与股外侧肌粘连,质中等.无灼热感.穿刺抽出为粘稠血脓样液体。包块穿刺液涂片:红细胞(++++).白细胞(—)。培养出金黄包葡萄球菌.碱性磷酸酶8.5金氏单位.入院1星期血常规:血色素11.3g,红血球40g
Patient, male, 32 years old, hospital number 14762. A year ago, there was an analgesic mass on the right thigh, the joint activity was normal, and then gradually increased. There was local tenderness. The mass growth rate was rapid in the past 4 months, often with low fever, obvious tenderness of the mass, and joint function. There was a stable gait and he was admitted to hospital on January 30, 1986. Physical examination: T38 °C, P88, BP120/80. Symmetrical thorax, the middle and lower parts of both lungs can be heard in scattered wet rales. The heart did not listen to pathological murmurs. Abdomen was soft and liver card was not. Both sides of the groin can be seen and several lymph nodes with a diameter of about 1 cm have good activity. The left upper soft tissue of the right femur showed a massive mass of 14.5 x 12 x 5.3 cm~3, with an uplift in the middle. The surface was purple-red, smooth, and there was a sense of volatility in pressure and no vascular beats. Basal and vastus lateralis muscle adhesion, medium quality. No burning sensation. Puncture out of viscous blood and pus-like liquid. Mass puncture liquid smear: red blood cells (++++). WBC (-). Culture Golden Staphylococcus aureus. Alkaline Phosphatase 8.5 Gold Unit. Admission to the hospital 1 week Blood routine: hemoglobin 11.3g, red blood cell 40g