论文部分内容阅读
患者女性,31岁,上腹部不规则烧灼样疼痛伴(口恶)心、反酸1年余。近1月来疼痛渐加重,解柏油样大便2次。查体:剑突下偏左压痛明显,未扪及包块。肝脾及全身浅表淋巴结不肿大。胃镜检查:发现胃小弯近幽门处有一溃疡。实验室检查:血红蛋白78g/L白细胞11.4×10~9/L,中性72％,淋巴25％,嗜酸性3％。大便隐血试验(++++)。临床诊断:胃慢性溃疡伴出血。术中见:胃小弯距幽门约3cm处有一硬性肿块,周边界不清,与小网膜紧密粘连。小弯侧见肿大淋巴结2枚。术中疑诊溃疡癌变,行胃大部切除术加胃周淋巴结清扫,毕氏Ⅱ式吻合。
The female patient, 31 years old, had abnormal epididymal pain in the upper abdomen with (bad) heart and acid reflux for more than one year. Pain increased gradually in the past month, and tar-like stools were relieved twice. Physical examination: The xiphoid submandibular left tenderness was obvious, and was not palpable. The liver, spleen, and superficial superficial lymph nodes are not swollen. Gastroscopy: It was found that there was an ulcer near the pylorus in the minor curvature of the stomach. Laboratory tests: Hemoglobin 78g/L white blood cells 11.4 × 10~9/L, neutral 72%, lymph 25%, eosinophilic 3%. Fecal occult blood test (++++). Clinical diagnosis: chronic gastric ulcer with bleeding. During the operation, the small curvature of the stomach has a rigid mass about 3 cm away from the pylorus. The perimeter is not clear and closely adheres to the small omentum. Small bends see two enlarged lymph nodes. Suspected cancerous ulcers during operation, subtotal gastrectomy plus lymph node dissection, and Pilz II anastomosis.