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患者,女,32岁,已婚。因月经不调、泌乳、不育3年,视力进行性减退,头痛月余,于1988年2月29日入院。头颅CT扫描示鞍上及鞍右高密度改变。抽血检查为行经后第5天,血PRL 327.1μg/L,FSH 17.8 IU/L,LH 1.3 IU/L,E_2 101.3pmol/L。诊断为垂体腺瘤,并在全麻下行垂体腺瘤摘除术,手术经过顺利。术后病理诊断:脑垂体嫌色细胞瘤。术后病人有一定恢复,头痛消失,视力有轻度改善。术后25天开始放疗,一个月后病人出现上腹部疼痛,伴有恶心、呕吐,呕吐物为咖啡色液体,拟诊为应激性溃疡,给予对症处理,症状无明显改善。经追问病史得知,患者2年前即出现不规则的上腹部疼痛,与饮食无关,再次体检后发现上腹部剑突下有一5×4×4 cm大小包块,质
Patient, female, 32 years old, married. Because of irregular menstruation, lactation, and infertility for 3 years, her vision deteriorated and she had a headache for more than one month. She was admitted to hospital on February 29, 1988. Skull CT scans showed high-density changes in the upper and lower saddle. Blood tests were performed on the 5th day after menstruation, with a blood PRL of 327.1 μg/L, FSH of 17.8 IU/L, LH of 1.3 IU/L, and E_2 of 101.3 pmol/L. The pituitary adenoma was diagnosed and the pituitary adenoma was removed under general anesthesia. The operation was successful. Pathological diagnosis: pituitary chromocytoma. After the operation, the patient recovered, his headache disappeared, and his eyesight improved slightly. Radiotherapy began 25 days after the operation. One month later, the patient developed upper abdominal pain, accompanied by nausea and vomiting. The vomit was brown liquid. The patient was diagnosed as stress ulcer and was given symptomatic treatment. There was no significant improvement in symptoms. According to the history of the patient, the patient experienced irregular epigastric pain 2 years ago. It had nothing to do with the diet. After the physical examination, he found a 5×4×4 cm mass under the xiphoid abdomen.