UNASSIGNED: The primary diagnosis in this case is systemic sclerosis (scleroderma) in a 47-year-old female patient with various clinical manifestations, including vesicovaginal and vesicorectal fistulas. The medical interventions and diagnostic workup involved an electrocardiogram, cardiac echocardiogram, pulmonary function tests, beta blockers, aspirin, inhaled corticosteroids, albuterol, endoscopy, biopsy, treatment for Helicobacter pylori infection, fluconazole for candida esophagitis, endoscopic dilation for achalasia, anticholinergic therapy for mixed urinary incontinence, gabapentin for neuropathic symptoms, analgesia for knee pain, and psychiatric treatment with selective serotonin reuptake inhibitors. The outcomes described in the case report include the diagnosis of systemic sclerosis, the identification of vesicovaginal and vesicorectal fistulas, the patient\'s medical history and symptoms over the years, and various treatments and management strategies.
■在这种情况下,主要诊断是一名47岁女性患者的系统性硬化症(硬皮病),具有各种临床表现,包括膀胱阴道瘘和膀胱直肠瘘。医疗干预和诊断检查涉及心电图,心脏超声心动图,肺功能检查,β受体阻滞剂,阿司匹林,吸入皮质类固醇,沙丁胺醇,内窥镜检查,活检,治疗幽门螺杆菌感染,氟康唑用于念珠菌食管炎,内镜扩张术治疗贲门失弛缓症,抗胆碱能治疗混合性尿失禁,加巴喷丁治疗神经性症状,膝关节疼痛镇痛,和选择性5-羟色胺再摄取抑制剂的精神治疗。病例报告中描述的结果包括系统性硬化症的诊断,膀胱阴道瘘和膀胱直肠瘘的鉴定,患者多年来的病史和症状,以及各种治疗和管理策略。