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rgb(0, 0, 255);">有問必答>></span></a> </td> <td style="border-style: solid; border-color: #fff;color: #333; background-color: #f1fbff;padding: 10px 5px;"> <a href="http://thedailypurge.net/OtherItem/baomingpingce/index2.shtml" target="_blank" style="color: rgb(0, 0, 255); text-decoration: underline;"><span style="color: rgb(0, 0, 255);">報考測評>></span></a> </td> </tr> </tbody> </table> <p></p> </span> </div>  <div id="zs7eok4" class="news_con"> <div id="afwfpwz" class="jxbox clearfix"> <p style="text-align: left;">右側(cè)輸尿管結(jié)石病例分析——臨床執(zhí)業(yè)醫(yī)師實踐技能模考的內(nèi)容，相信大家都在關注，該試題網(wǎng)校講義中有還原考點練習題，為大家總結(jié)整理如下，還沒有考試的考生可以參考復習：</p><section data-id="1925" style="color: rgb(51, 51, 51); white-space: normal;"><section style="margin: 5px 0px 0px; padding: 10px; border: 2.1px dashed rgb(182, 182, 182); line-height: 25px; background-color: rgb(244, 244, 244);"><p style="text-align: left;">男，36歲。突發(fā)右腰部絞痛伴血尿2小時。</p><p style="text-align: left;">患者2小時前劇烈活動后突然出現(xiàn)右腰部絞痛，疼痛呈持續(xù)性，陣發(fā)性加重，向右側(cè)會陰區(qū)放射，坐立不安，伴大汗、惡心，嘔吐胃內(nèi)容物2次。排尿時可見尿呈粉紅色，量約200ml/次。既往體健。吸煙10年，10支/日。</p><p style="text-align: left;">查體：T37.5℃，P90次/分，R18次/分，BP130/70mmHg。神志清楚，輾轉(zhuǎn)不安。瞼結(jié)膜無蒼白，雙肺呼吸音清。心率90次/分，律齊。腹部平坦，未見胃腸型、蠕動波，全腹無壓痛，無反跳痛、肌緊張，腸鳴音6次/分，右腎區(qū)叩擊痛（+）。</p><p style="text-align: left;">實驗室檢查：血常規(guī)：Hb135g/L，WBC11.2×109/L，N0.82，PLT247×109/L。</p><p style="text-align: left;">泌尿系B超：右側(cè)腎盂和近段輸尿管擴張，距離腎門4cm處可見一強回聲光團，大小約7mm，后伴聲影，遠段輸尿管顯示不清。</p></section></section><section data-id="1750" style="color: rgb(51, 51, 51); white-space: normal;"><blockquote style="margin: 0px; padding: 15px; border-radius: 7px; border: 2px solid rgb(255, 85, 95); text-align: left;"><p style="text-align: left;"><strong>一、初步診斷（5分）</strong></p><p style="text-align: left;">1.右側(cè)輸尿管結(jié)石（答“右腎絞痛”得2分）。（3分）</p><p style="text-align: left;">2.右腎積水。（2分）</p><p style="text-align: left;"><strong>二、診斷依據(jù)（5分）</strong></p><p style="text-align: left;">1.右側(cè)輸尿管結(jié)石</p><p style="text-align: left;">（1）劇烈活動后，右腰部絞痛伴肉眼血尿。（1分）</p><p style="text-align: left;">（2）疼痛向會陰區(qū)放射，伴惡心、嘔吐。（1分）</p><p style="text-align: left;">（3）右側(cè)腎區(qū)叩擊痛（+）。（1分）</p><p style="text-align: left;">（4）泌尿系B超：右側(cè)腎盂和近段輸尿管擴張，距離腎門4cm處可見一強回聲光團，大小約7mm，后伴聲影。遠段輸尿管顯示不清。（1分）</p><p style="text-align: left;">2.右腎積水：泌尿系B超：右側(cè)腎盂和近段輸尿管擴張。（1分）</p><p style="text-align: left;">男性，75歲。進行性排尿困難5年，不能排尿4小時。</p><p style="text-align: left;"><strong>三、鑒別診斷（4分）</strong></p><p style="text-align: left;">1.膀胱結(jié)石。（1分）</p><p style="text-align: left;">2.急性泌尿系感染。（1分）</p><p style="text-align: left;">3.急性闌尾炎。（1分）</p><p style="text-align: left;">4.急性<a href="http://thedailypurge.net/jibing/dannangyan/" target="_blank" title="膽囊炎" style="text-decoration-line: none; color: rgb(0, 0, 255); outline: none;">膽囊炎</a>或胰腺炎（答對其中一個即可得1分）。（1分）</p><p style="text-align: left;">四、進一步檢查?。?分）</p><p style="text-align: left;"><strong>1.尿常規(guī)。（1分）</strong></p><p style="text-align: left;">2.泌尿系X線平片。（1分）</p><p style="text-align: left;">3.尿路造影或CT。（答對其中一個即可得1分）（1分）</p><p style="text-align: left;">4.腹部B超。（1分）</p><p style="text-align: left;"><strong>五、治療原則（4分）</strong></p><p style="text-align: left;">1.解痙，止痛治療，應用抗生素。（1.5分）</p><p style="text-align: left;">2.解除尿路梗阻（介入或碎石）。（1.5分）</p><p style="text-align: left;">3.必要時手術（常規(guī)或微創(chuàng)）。（1分）</p></blockquote></section><section data-id="1750" style="white-space: normal; color: rgb(51, 51, 51);"></section><p style="text-align: left;"><strong>編輯推薦：</strong></p><p style="text-align: left;"><a href="/linchuangyishi/jinengfudaopeixun/su2112243792.shtml" articlerela="4773518" target="_blank">臨床執(zhí)業(yè)醫(yī)師實踐技能考試病例題14道！附詳細評分標準！</a></p><p style="text-align: left;"><a href="/linchuangyishi/jinengfudaopeixun/su2112135577.shtml" articlerela="4766963" target="_blank">這些題學長考過？2022年臨床執(zhí)業(yè)醫(yī)師技能歷年?？?0套卷！</a></p><p style="text-align: 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