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患者,女,25岁。已婚未育。发现腹部增大8年,右上腹痛3天入院检查。一般状态佳,神清,无贫血貌,体形消瘦,腹部膨隆。患者月经规律,量中等,偶发痛经,无尿频尿急,无排便费力。妇科检查:子宫体触不清,整个盆腔触及一巨大包块,上界达剑下,质较硬,活动不佳,双附件触不清。 彩色多普勒超声检查:子宫仅显示宫颈,双附件区未见异常。整个腹腔为一巨大不均质的实性包块占据,超声屏幕不能显示该肿物全貌,经拼接测量,该肿物大小约为25×23×9cm,内见数十个大小不等的不均质低回声结节,间杂无回声区,轮廓极其不规则。CDFI可见丰富血流信号,峰值流速达174.9cm/s,阻力指数0.4;因其内部可见一较粗大的条状强回声与宫颈内膜相通,及双侧卵巢可见,肝、胆、胰、脾、肾未见异常,故诊断为子宫肌瘤伴变性。
Patient, female, 25 years old. Married and not educated. Found that the abdomen increased 8 years, right upper abdominal pain 3 days admission examination. The general state of good, clear, anemic appearance, body weight loss, abdominal bulging. Patients with regular menstruation, the amount of moderate, occasional dysmenorrhea, urinary frequency urgency, no defecation effort. Gynecological examination: the uterus body palpable, the pelvic mass touched a huge mass, the upper limit of the sword, the quality of hard, poor activity, double attachment touch. Color Doppler ultrasound examination: the uterus shows only the cervix, double attachment area no abnormalities. The entire abdominal cavity is a huge heterogeneous solid mass occupied, the ultrasound screen can not display the entire picture of the tumor, the splicing measurement, the tumor size of about 25 × 23 × 9cm, see the dozens of different sizes do not Homogeneous hypoechoic nodules, no echo between the area, the outline is extremely irregular. CDFI visible rich blood flow signal, the peak flow rate of 174.9cm / s, resistance index of 0.4; because of its internal appearance of a thick strip of echogenic and cervical endometrial communication, and bilateral ovarian visible, liver, gallbladder, pancreas, spleen , No abnormal kidney, so the diagnosis of uterine fibroids with degeneration.