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一、病例分析例1:经产妇39岁。25岁时正常分娩一次。主诉一年半以前开始月经血量增多,且有痛经。于1983年9月8日来院求治。末次月经1983年8月5日量较多,同时伴有腹痛。既往月经规律,量不多,未婚时曾在某院检查有淋巴结核,曾行抗结核治疗。5年前妊娠3个月自然流产后清宫,术后发烧三天,曾用抗菌素治疗。以后每次空腹时,曾在下腹部摸到包块,且有压痛。盆腔检查:子宫超鹅卵大,球形韧性感,有轻度压痛。右侧附件可触及7×5×4立方厘米大小包块,不活动,触痛明显。左侧附件增厚。探查宫腔9厘米,宫颈Ⅱ°糜烂,阴道分泌物白色,中等量。余(-)。化验检查:血红蛋白11克％,白细胞7400,分类正常,血沉8毫米,根据病史应做出何种诊断,
First, case analysis Example 1: The maternal age of 39 years. Normal birth at 25 years old. A year and a half ago, began to increase menstrual blood volume, and dysmenorrhea. In September 8, 1983 to court for treatment. The last menstrual August 5, 1983 the amount of more, accompanied by abdominal pain. Previous menstrual regularity, a small amount, unmarried had a check in a hospital with lymph node tuberculosis, had anti-TB treatment. 5 years ago 3 months after pregnancy spontaneous abortion Qing, postoperative fever for three days, once treated with antibiotics. After each fasting, had touched the mass in the lower abdomen, and tenderness. Pelvic examination: large super-goose uterus, spherical toughness, mild tenderness. The right attachment can reach the size of 7 × 5 × 4cm3 mass, no activity, obvious tenderness. Thickening left attachment. Exploration of the uterine cavity 9 cm, cervix Ⅱ ° erosion, vaginal discharge white, medium amount. I (-). Laboratory tests: hemoglobin 11%, white blood cells 7400, normal classification, erythrocyte sedimentation rate 8 mm, according to medical history should make what kind of diagnosis,