肢端型系统性硬皮病1例

1　病例报告　女 ,45岁 .因吞咽困难 16 mo伴发热 15 d于1999- 0 1- 12入院 . 16 mo前因与人争吵后出现吞咽困难 ,以进米、面食为主 ,且剑突下间断出现梗噎感 ,随即呕吐 ,呕出所进食物及粘液 ,无胃内容物 .进流食、饮水无异常 ,情绪波动可诱发症状加重 ,并伴食欲减退、返酸以及上腹部不适 . 15 d前无明显诱因出现不规则发热 ,T38～ 39℃ ,腹痛加重 ,全身酸困不适 ,乏力、头晕、消瘦 ,体质量下降 30 kg.追问病史 ,患者5 a前双手、足疼痛并伴麻木 ,尤以受凉、精神刺激后明显 ,指(趾 )端出现苍白 ,继而发紫、变红 ,且麻木疼痛加重 .手足小关节…     

中西医结合治疗肢端型系统性硬皮病

笔者应用中西医结合方法治疗肢端型系统性硬皮病1例,报道如下。     

二例肢端型系统性硬皮病水肿期临床表现

肢端型硬皮病为系统性硬皮病的一种临床型 ,由于其病情进展较缓慢 ,内脏受累较轻 ,特别在水肿期 ,其临床特征不明显 ,易以水肿原因不明而延误诊治。现介绍 2例水肿期临床病例以更好地认识本病。1　临床资料例 1,许某 ,男 ,30岁。面部水肿半年 ,四肢水肿伴关节疼痛 3月。患者半年前无明显诱因出现面部水肿 ,因当时无明显其它不适 ,未予诊治。 2 0 0 0年 3月起 ,又出现四肢水肿 ,同时伴大关节酸痛不适 ,遂到当地县医院诊治。多次检查为低热 ,血沉 10 2ｍｍ/ｈ ,三大常规、肝肾功能、电解质、Ｔ3、Ｔ4 、ＴＳＨ、胸片、心电图、超声心动图等均…     

系统性硬皮病致呼吸循环衰竭1例

1 临床资料 患者,女性,63岁,汉族,乌市退休工人,因“胸闷气短心慌反复发作两年,加重两月”于2000年12月12日就诊我院。既往1999年4月曾在活动中突发恶心欲呕、大汗、胸闷气短心慌,在兰州军区乌鲁木齐总医院就诊,查心电图示异位心律,心房纤颤,     

Graves病并肢端性硬皮病1例

患者 ,女性 ,2 9岁。以颈粗、下肢肿胀 ,伴活动后心悸、气促 2年于 2 0 0 2年 8月 2 3日入院。平素伴有怕热 ,但出汗不多 ,尤以下半身明显 ,伴烦躁失眠、易疲劳 ,1年来双下肢肿胀 ,皮肤僵硬且逐渐加重 ,蔓延至大腿及脐以下的腹部 ,致腹肌肿胀 ,腹围增宽 ,伴面部皮肤绷紧 ,双膝关节肿大 ,行走时觉下肢沉重 ,体重由发病至入院增加约 15kg ,伴双手微震颤 ,双眼外突 ,食欲一般 ,无张口困难及吞咽困难 ,且有雷诺现象。月经周期不规则 ,经量减少。查体 :T 36 .4℃ ,P 10 0次 min ,R 2 0次 min。营养中等 ,双眼球稍外突 ,面肌无表情 ,双侧甲状…     

系统性红斑狼疮21例误诊分析

系统性红斑狼疮(SLE)是一种多发于青年女性的自身免疫性累及多脏器的炎症性结缔组织病,临床表现复杂、变化多样。我院从1991～1996年共收治SLE48例,其中确诊前误诊21例,误诊率43.75％。现分析如下。     

中西医结合治疗系统性硬皮病1例

中西医结合治疗系统性硬皮病１例李锋李秀云张仲海（第四军医大学西京医院中医科西安７１００３３）关键词系统性硬皮病／药物疗法中西医结合疗法中图号Ｒ７５８．６１病例患者马××，男，４２岁，因双手、面部皮肤发硬３月，加重伴消瘦１月入院．自述面部、双手皮肤变硬...     

系统性硬皮病弥漫型伴脂膜炎1例

男患 ,14岁 ,因周身硬化伴发热 3年 ,加重半年 ,于 2 0 0 0年 10月 7日以“硬皮症”收入院。患儿 6年前曾患肾病综合征 ,由于反复发作曾用过大量激素 ,3年前患儿以双肩关节剧烈疼痛起病 ,口服可待因无效 ,约 10天后躯干出现限局性硬结并迅速连成片 ,延及全身 ,尤以躯干及四肢近端为著 ,同时皮肤增厚颜色加深伴疼痛 ,半月后疼痛渐缓解。本次入院查体 :ＫＴ :38℃ ,Ｐ116次 /分 ,Ｒ34次 /分 ,ＢＰ因上臂皮肤硬化未测到。满月脸 ,发育略差于正常同龄儿 ,躯干及四肢近端硬化呈盔甲状 ,深褐色 ,有蜡样光泽 ,不能用手捏起 ,硬化处无毛发 ,皮纹消失…     

系统性硬皮病累及食管上段1例

系统性硬皮病累及食管上段１例全世杰孙希芹管艳杰（潍坊市人民医院潍坊２６１０４１潍坊医学院附属医院）系统性硬皮病除皮肤改变外尚可有多脏器的受累〔１～３〕。消化道是常被累及的脏器之一，但首先累及食管上段者，文献报告尚少，我们发现１例，报告如下：患者，...     

鼻瓣区狭窄误诊原因分析

鼻瓣区狭窄发病率低，但由于对其认识不足，因此，误诊率极高。我科自2004—2008年共收治鼻瓣区狭窄患者11例，报道如下。     

原发性胃肠恶性淋巴瘤误诊分析

目的：探讨原发性胃肠道恶性淋巴瘤的误诊原因。方法：对我科2000年5月～2006年7月收治的22例原发性胃肠道恶性淋巴瘤的临床资料进行回顾性分析。结果：22例均行胃肠镜及病理检查。其中,胃淋巴瘤15例：仅1例确诊,术前10例误诊为胃低分化腺癌,3例误诊为胃未分化腺癌,1例误诊为胃溃疡。肠淋巴瘤7例：也仅1例确诊,2例误诊为肠结核,4例误诊为腺癌。22例均行手术治疗,术后1例出现切口感染,1例出现肺部感染,并发症和其他手术相比无差异。经治疗后均全部顺利出院。术后给予化疗,无一例死亡。结论：原发性胃肠道恶性淋巴瘤误诊率高,手术和术后病理免疫组化检查是主要的确诊方法,手术联合化疗具有较好的疗效。     

A case report on bezoar

A nine years old girl was admitted into the paediatric surgery word of Dhaka Medical College Hospital (DMCH) with upper abdominal mass and discomfort, was diagnosed radiologically as a case of gastric bezoar which was further confirmed by endoscopy as trichobezoar (hair ball). The girl was undergone laparotomy and trichobezoar was removed from stomach by gastrostomy. After ten days of operation she became well and was discharged from the hospital.     

一例大学新生适应不良的案例报告

求助者不能接受理想和现实的差距,学习上缺乏动力,自我评价降低,回避人际交往,有明显的焦虑、抑郁情绪,有人际关系敏感和头痛、失眠等躯体症状,诊断为一般心理问题。采用现实疗法和认知-行为疗法。经过4次咨询,躯体症状得以缓解,人际关系显著改善,自信心明显增强,心理适应能力有了很大提高。     

A case report on Klinefelter syndrome

An 18 year old boy presented with small genitalia, failure of eruption of secondary sex hairs, female like voice with eunachoid body habitus, bilateral gynecomastia, infantile external genitalia, small testes and poorly developed musculature. He was diagnosed as a case of 47XXY Klinefelter syndrome on the basis of hormone assay and karyotyping. He has given androgen replacement therapy with the aim to relieve symptoms of androgen deficiency, to reproduce physiological levels of plasma testosterone and to prevent long term consequences of androgen deficiency.     

A case report on Wilson's disease

A case of Wilson's disease, a rare autosomal recessive disorder of copper metabolism is reported here. The patient was presented with the difficulty in speech and writing for 4 years and also on walking for 1 year. He also noticed difficulty to perform any work by hands for 6 months. He had splenomegaly and bilateral gynaecomastia. His speech was low volume slurred and monotonous, muscle tone was mildly increased, and gait was limping. Slit lamp examination of eye revealed bilateral Kayser-Fleischer ring with normal visual acuity. Investigations revealed low serum albumin(26 gram/L), increased alanine trans-aminase ( A.L.T=57 U/L). Ultrasonogram of hepatobiliary system revealed coarse hepatic tissue echotexture with splenomegaly. Liver scan showed slightly nonuniform radiotracer distribution in the liver, there was slight increased bony uptake. Serum caeruloplasmin level was 11.51 mg/dl. 24 hours urinary copper excretion was 150 microgram per day. Liver biopsy revealed cirrhotic change. Now he was advised for taking copper chelating agent (penicillamine) in a dose of 1 gram/day.     

A case of tubulopapillary hidradenoma on the face

To the editor： In September 2013 ur department with a lesion on a 60-year-old man presented to left face. The lesion was found about one year ago without previous trauma or any other reasons, and enlarged slowly accompanying occasional itch. The medical and family histories were unremarkable. On dermatological examination, a solitary red-brown colored, firm, non-tender, mobile nodule of 0.8 cm diameter was seen on the left face. The surface of the nodule was smooth （Figure IA）. Provisional diagnoses of fibroma or sebaceous cyst were made. The lesion was excised and sent for histopathological examination.