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病历摘要王某,女,62岁,农民,已婚.因外阴搔痒2月余就诊于某肿瘤医院,发现宫颈息肉,摘除病检为宫颈原位癌累腺,即于1986年9月30日入我院.患者以往无接触性出血史,绝经后无不规则阴道出血.一贯来白带不多,色泽无殊,近2月也无白带增多现象.初潮16岁,周期准,无痛经史,52岁绝经.17岁结婚,7-0-0-5,19岁第一次生育,均为顺产,无产褥感染及产后出血史. 体检:一般情况良好,血压16.00/9.33kPa,心肺无异常,肝脾未及,腹壁脂肪较肥厚.妇科检查:外阴发育无异常,阴道壁
Medical history summary Wang, female, 62 years old, farmer, married due to genital itching more than 2 months treatment at a tumor hospital and found that cervical polyps, removal of disease examination for cervical cancer in situ, that is, September 30, 1986 Into our hospital patients with non-contact history of bleeding in the past, no irregular vaginal bleeding after menopause. Lean vaginal discharge has always been small, no special color, no leucorrhea in recent February phenomenon. Menarche, 16-year cycle, quasi-painless, 52 Year-old married, 17-year-old married, 7-0-0-5, 19-year-old first childbirth, all with a history of quiescence, no puerperal infection and postpartum haemorrhage.Physiological examination: generally good, blood pressure 16.00 / 9.33kPa, Lack of liver and spleen, abdominal fat more hypertrophy. Gynecological examination: no abnormal vulva development, vaginal wall