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[编者按 ] 这是一篇来自县级医院的病例讨论。作者对 1例经 2次手术的病例进行了临床分析讨论 ,针对具体病例又结合该院的实际 ,认识并找到了第 1次手术未能确诊的原因 ,这无疑是十分有意义 ,又难能可贵的。我们刊出本文旨在提倡基层医院能结合日常工作中的疑难问题进行分析讨论。总结经验教训 ,从而提高自己的诊治水平 ,这是一项切合实际又不难办的好事 ,坚持下去必有好处。此次讨论中也存在有明显的不足之处 ,诸如 :①第 1次剖腹探查术为什么未探查到原发疾病 ;②第 2次入院时右侧腹可及 18cm× 2 3cm肿块 ,为什么不做B超检查 ;③这次讨论的主要收获是什么 ,哪些问题有待今后改进 ,文章中均未涉及。这些都有待在今后的讨论中进一步深入提高。我们欢迎并鼓励基层医院踊跃投稿。
[Editor’s note] This is a case study from a county hospital. The author of a case of 2 surgeries conducted clinical analysis and discussion, for specific cases combined with the hospital’s actual situation, to recognize and find the first surgery failed to diagnose the cause, which is undoubtedly very meaningful and commendable . We published this article aimed to promote grassroots hospitals can combine the daily work of the difficult problems for analysis and discussion. Summarizing the experience and lessons to improve their own diagnosis and treatment level, this is a practical and not difficult to do a good thing, it will be beneficial to persevere. There are also obvious deficiencies in this discussion, such as: ① why the first laparotomy did not detect the primary disease; ② on the second admission right flank and 18cm × 2 3cm mass, why not do B-ultrasound; ③ What are the main gains of this discussion and what issues need to be improved in the future, none of which are covered in the article. All this needs to be further deepened in future discussions. We welcome and encourage grass-roots hospitals to submit their contributions.