@wmq1009:17 JSONTXT

{"project":"ICU_characters","denotations":[{"id":"T1","span":{"begin":5,"end":8},"obj":"doctor"},{"id":"T10","span":{"begin":852,"end":857},"obj":"diagnosis"},{"id":"T2","span":{"begin":9,"end":19},"obj":"date"},{"id":"T3","span":{"begin":19,"end":27},"obj":"time"},{"id":"T4","span":{"begin":28,"end":535},"obj":"other_rec"},{"id":"T5","span":{"begin":535,"end":539},"obj":"other_rec"},{"id":"T6","span":{"begin":522,"end":527},"obj":"something"},{"id":"T7","span":{"begin":829,"end":833},"obj":"type"},{"id":"T8","span":{"begin":835,"end":839},"obj":"diagnosis"},{"id":"T9","span":{"begin":841,"end":848},"obj":"diagnosis"}],"relations":[{"id":"R1","pred":"combine_time","subj":"T2","obj":"T3"},{"id":"R2","pred":"depen","subj":"T1","obj":"T7"},{"id":"R3","pred":"detail_infor","subj":"T7","obj":"T8"},{"id":"R4","pred":"detail_infor","subj":"T7","obj":"T9"},{"id":"R5","pred":"detail_infor","subj":"T7","obj":"T10"}],"text":"0030^刘续宝*2018-11-2920:56:58*患者田迎,女,64岁8月,因“胰十二指肠切除术后13天,突发腹痛3小时.”入院.其主要病史特点如下1、老年,女性2、起病急,病程短3、患者于入院13天前,因\"胰头占位\"于我科行\"胰十二指肠切除术\",术后积极予以抗炎,抑酸护胃,抑酶,补液等支持治疗,症状好转后出院.3小时前,患者无明显诱因出现腹部疼痛不适,以下腹部为甚,为持续性胀痛,难以忍受,无畏寒,发热,无恶心,呕吐,无胸闷,气短,呼吸困难等不适,遂就诊于我院,急诊以\"腹痛待诊\"收入我科.病程中,患者神清,精神欠佳,急性痛苦面容,未进食..4、既往史:13天前因\"胰头占位\",于我科行\"胰十二指肠切除术\",否认肝炎、结核或其他传染病史,否认过敏史,否认手术史.5、查体T36.4℃,P101次分,R20次分,BP11866mmHg.神志清楚,急性病容,皮肤巩膜无黄染,全身浅表淋巴结未见肿大.颈静脉正常.心界{心界情况},心律{心律},各瓣膜区未闻及杂音.胸廓未见异常,双肺叩诊呈清音,双肺呼吸音清,未闻及干湿啰音及胸膜摩擦音.腹部外形正常,全腹压痛,以下腹部为甚,伴反跳痛及肌紧张,腹部未触及包块,肝脏肋下未触及,脾脏肋下未触及,双肾未触及,双下肢无水肿.辅助检查2018-11-29我院CT1.“胰十二指肠切除术后“,胰头、胆囊、十二指肠未见显示,术区结构紊乱,胆肠、胃肠及胰肠吻合口肿胀,肝内胆管轻度扩张,术区脂肪间隙肿胀,前腹壁少量积气,腹腔积液并多处包裹,腹腔见数根引流管影.2.肝脏右后叶及左外叶见数个稍低密度结节影,较大位于右后叶下段,大小约2.2x1.3cm的稍低密度结节影,边界欠清晰,形态不规则,动脉期见轻度边缘强化,门脉期呈低密度,性质胆源性感染待排,请结合临床及其他检查,随访复查.3.左侧肾上腺体部强化结节,大小约1.3x1.0cm,边界较清晰,腺瘤或其他请结合临床及并随访.4.双肾囊肿.5.双侧胸腔积液,双肺下叶实变初步诊断1)腹痛待诊2)胰十二指肠切除术后3)左侧乳腺癌术后.经积极术前准备,于2018-11-29行胆肠吻合术,术中见术中见腹腔内大量胆汁样液体,胰管脱落后至胆肠吻合口后形成大小约0.5*0.5cm的瘘口手术顺利,术后返回SICU进一步治疗.\r\n"}