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英文出院小结模板   Discharge report gynecology Bed number: 15 Name: LIN YUAN Birth 1962.6.5 Gender: female Age: 50 Y Number in hospital:11214696 Check-in time: 2012-07-05 16:50:00 ...

英文出院小结模板
  Discharge report gynecology Bed number: 15 Name: LIN YUAN Birth 1962.6.5 Gender: female Age: 50 Y Number in hospital:11214696 Check-in time: 2012-07-05 16:50:00 Check-out time: 2012-07-07 14:00:00 Days: 2 Outpatient endometrial diseases Hospital check endometrial diseases Discharge check endometrial diseases Main disease LIN YUAN,female,age 50,move in hospital by menstrual uncleaning。No Abdominal pain,little colpo-blood,sleep well,fece and urine well。Check:vulvae :(-),vulvae unhindered,and little Coffee object,cervix:nice。Uterine precursor:slightly larger and hard,:In addition can see small piece of 3*3*3cm. Main Test results (July 6,in hospital) leucorrhea test nice. Blood coagulation、blood test、electrocardiogram test nice. Pregnancy tests (-);Liver and kidney’s electrolyte:normal;Infectious diseases:Hepatitis b core Ab(all),7.07S/CO,↑;Hepatitis b exterior Ab,14.55mIU/ml。 Cure process and Treatment result LIN YUAN took participate in related tests without operation taboo after be in hospital. ,then she was operated by sbvein anesthesia hysteroscopy operation :uterine shape was normal,endometrium was thicker and could be find polyps,brought sth which was tested in pathology in endometrium by spoon. After successful operation,she was treated by anti-infection treatment. And now, Linyuan got well and her lead doctor allowed her to leave hospital. Syndrome nothing Health after out of hospital The patient got well without fever and abdominal pain, just little colpo-blood. eat well,fece and urine well,sleep well。PE:Spirit well,no pain. No Gynecologial Examination Doctor orders after out of hospital 1.relaxing、nutrition,without sex and bath. Ask about the situation after a week 2.drugs:BZYM granule ×3 box tid,double tablets,oral. 3.If vaginal bleeding, please return to the hospital Treatment result Heal   Lead doctor resident Date                                                     gynecology Bed number: 15 Name: LIN YUAN Birth 1962.6.5 Gender: female Age: 50 Y Number in hospital:11214696               Pathological Report:Secretory endometrium with the formation of polyps.
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