论文部分内容阅读
患者牛某 女,54岁,农民。进行性吞咽困难一个半月,开始尚能进食软干饭,以后出现进食后梗阻感及胸部胀感,仅能进食稀饭,并且自觉梗阻感逐渐加重,随后出现咳嗽,气喘,有时伴有咯血。在县医院诊断不清而转入我院门诊。入院体检:神志清,呼吸平稳,重度贫血貌,心率82次/分,律齐。右肺呼吸音明显低于左肺。腹软,肝脾未触及,腹水征(-),未触及包块。食道钡透:食道中下段有一段5cm左右的狭窄段。肌注654-210mg,仍为狭窄,拟诊食管癌。纤维胃镜检查:食道中下段有一段狭窄,但食道粘膜表面光滑,未见明显溃疡及新生物,狭窄部充气扩张尚可。胃镜检查未见食管癌征象。胸片
The patient was a 54-year-old farmer. One-and-a-half months of progressive dysphagia, still able to eat soft dry rice, after the emergence of a sense of obstruction and chest bulging after eating, can only eat porridge, and gradually increased conscious obstruction, followed by cough, wheezing, sometimes accompanied by hemoptysis. Undiagnosed in the county hospital and transferred to our hospital. Admission examination: clear mind, stable breathing, severe anaemia, heart rate 82 beats/minute, law uniform. Right lung breath sounds are significantly lower than left lungs. Soft abdomen, untouched liver and spleen, ascites sign (-), untouched mass. Esophageal fistula: There is a narrow segment of about 5cm in the lower esophagus. Intramuscular injection of 654-210mg, still stenosis, to diagnose esophageal cancer. Gastric endoscopy: There was a stenosis in the middle and lower esophagus, but the surface of the esophagus mucosa was smooth, no obvious ulcers and new organisms were seen, and the stenosis could still be inflated. Gastroscopy did not show signs of esophageal cancer. Chest