论文部分内容阅读
例1:陈某,男,29岁。因肛门右侧蚕豆大小结节,红肿疼痛一月余在外院行脓肿切开引流术,术后经抗炎处理一个多月,创口始终未愈而转我院。无发热咳嗽、胸痛、消瘦、盗汗等症状。查体:心尖部可闻及四级收缩期杂音,心脏向左扩大。膝胸位肛门指诊:肛门外口右下方(5点处)距肛缘3cm有一蚕豆大小的创面,创口不新鲜,色淡,有淡黄色分泌物流出;探针检查,窦道沿肛门后间隙上行,内口未探及;指诊未触及硬质肿块,指套无脓血、粘液。入院诊断:复杂性高位肛瘘。入院后胸部平片示右上肺浸润型肺结核,先天性心脏病(房间隔或室间隔缺损?),予以脓肿扩创手术,病理组织报告:结核性肉芽组织。术后创口换药及抗结核化疗,一月后创口愈合,拟肺结核好转后行肛瘘切除术。
Example 1: Chen, male, 29 years old. Because of the right anus, the size of broad beans nodules, swelling and pain more than a month in the hospital abscess incision and drainage, postoperative anti-inflammatory treatment more than a month, the wound has not healed and transferred to our hospital. No fever, cough, chest pain, weight loss, night sweats and other symptoms. Physical examination: the apex can be heard and four systolic murmur, heart to the left to expand. Chest anus Anal palpation: anal right lower right (5 o’clock) from the anal margin 3cm a broad bean-sized wound, the wound is not fresh, pale, a light yellow discharge out; probe examination, sinus along the anterior gap Up, the mouth was not explored; fingerprints did not touch the hard mass, refers to sets of no blood, mucus. Admission diagnosis: complex high anal fistula. After admission, the chest radiograph showed pulmonary infiltrate right upper pulmonary tuberculosis, congenital heart disease (atrial septal or ventricular septal defect?), To be abscess expansion surgery, pathology report: tuberculous granulation tissue. Postoperative wound dressing and anti-TB chemotherapy, wound healing after January, the proposed pulmonary tuberculosis improved anal fistula resection.