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患者,28岁,于1958年4月8日住院。主诉为闭经54天,阴道不规律流血18天,伴有下腹疼痛。于闭经38天时阴道即有不规律少量流血和下腹隐痛,临床诊断为先兆流产,给予溴剂及黄体酮治疗,历经16天病情未见好转。后因下腹疼痛加剧且伴有恶心呕吐及全身出虚汗而住院。1956年4月宫内足月妊娠臀位分娩一女婴,无产褥期感染历史。既往曾患“肺结核”。体格检查:发育及营养良好,急性病容,腹部稍隆起,腹肌紧张,左下腹有明显压痛及反跳痛。阴道检查:外阴经产型,宫颈光滑较软,有触痛;子宫体正常大小较软有浮悬感,后穹窿丰满,在左侧附体处扪及界限不清楚的肿块。化验检查:血色素8.5克%,红细胞268万/立方毫米,白细胞11,500/立方毫米,中性多核白细胞94%,淋巴球6%。临床印象为左侧输卵管妊娠破裂。手术所见:腹腔积血约700毫升,子宫体前倾位,增大如一月余孕,左侧输卵管变粗,约5.5×3×2厘米,未见裂口,伞端有血液浸出,卵巢与之粘连,因之作左侧输卵管卵巢摘除术。术后情况良好,于第五天阴道落出8×5×1厘米之子宫管型。病理检查:肉眼观察为手术摘除的左侧输卵管及卵巢,输卵管体积为5.5×3×2厘米,紫红色,表面光滑,有明显的血管充血,壶腹部膨大,伞端完整。在切面上管腔内充满陈旧的血凝块,在壶腹部发现二个胚囊,小的体积为3×1
The patient, 28 years old, was hospitalized on April 8, 1958. Chief complaint of amenorrhea for 54 days, vaginal irregular bloodshed 18 days, accompanied by abdominal pain. In the amenorrhea 38 days vaginal irregular bloodshed and lower abdominal pain, clinical diagnosis of threatened abortion, given bromine and progesterone treatment, after 16 days the condition has not improved. After the abdominal pain due to aggravating and accompanied by nausea and vomiting and body sweating and hospitalization. April 1956 a full-term intrauterine pregnancy breech delivery a baby girl, no history of puerperal infection. Previously had “tuberculosis.” Physical examination: good development and nutrition, acute disease, abdominal slightly elevated, abdominal muscle tension, left lower quadrant was tenderness and rebound tenderness. Vaginal examination: vulvar by the production type, the cervix is smooth and tender, tenderness; normal body size of the uterus is more floating sense of floating, after the dome fullness, palpable at the left posterior body palpable unclear mass. Laboratory tests: 8.5 grams of hemoglobin, 2.68 million / cubic mm of erythrocytes, 11,500 / cubic mm of white blood cells, 94% of neutral polymorphonuclear leukocytes, 6% of lymphocytes. Clinical impression of the left tubal pregnancy rupture. Surgical findings: about 700 ml of hemoperitoneum, uterine anterior body, such as more than a month pregnant, the left fallopian tube thickening, about 5.5 × 3 × 2 cm, no tears, the umbrella side of the blood leaching, ovarian and The adhesion, as a result of the left oviduct ovariectomy. Postoperative condition is good, on the fifth day the vagina drops 8 × 5 × 1 cm uterine tube type. Pathological examination: Surgical removal of the left oviduct and ovary, the tubal volume of 5.5 × 3 × 2 cm, purple, smooth surface, obvious vascular congestion, ampulla enlargement, umbrella-side integrity. In the section of the lumen filled with obsolete blood clots found in the ampulla two embryo sac, a small volume of 3 × 1