论文部分内容阅读
患者28岁,孕2产1,住院号34596。1980年3月13日因停经2个月,阴道流血,诊断为早孕,先兆流产,在门诊行刮宫术,术中出血较多,刮出物病理诊断为退化坏死的蜕膜及滋养叶组织。因术后仍有少量阴道流血,故一周后再次刮宫,血止。5月20日无何诱因突然下腹部疼痛,伴有便感4小时急诊入院。体检:T36.9℃,P90次/,R24次/分,Bp95/60mmHg。贫血貌,心肺无异常,腹部稍膨隆,未见肠型及蠕动波,全腹有压痛、反跳痛及肌紧张。肝脾未触及,可叩及移动性浊音。妇检:阴道通畅,穹窿饱满,宫颈光滑,有明显摇举痛,子宫及附件查不清。阴遭分泌物乳白色量少。血化验:Hb75g/L,RBC2.6×10~(12)/L,WBC1.3×10~9/L,N65%,L35%。入院诊断:异位妊娠,失血性休克。立即在硬膜外麻醉下拟行患侧附件切除术。术中见腹膜呈紫蓝色,用21号注射针头穿刺吸出腹腔内血液1300ml 回输,
The patient was 28 years old, pregnant and 2 producing 1, hospital number 34596. March 13, 1980 due to menopause 2 months, vaginal bleeding, diagnosis of early pregnancy, threatened abortion, curettage in out-patient clinic, more bleeding during surgery, scraping Pathological diagnosis of decidual necrosis of the decidua and nourishing leaf tissue. Because there is still a small amount of postoperative vaginal bleeding, so curettage again after a week, blood only. May 20 without any incentive suddenly lower abdominal pain, accompanied by a sense of 4 hours emergency admission. Physical examination: T36.9 ℃, P90 times /, R24 times / min, Bp95 / 60mmHg. Anemia appearance, no abnormal heart and lung, abdominal slightly bulging, no intestinal and peristaltic waves, the whole abdomen with tenderness, rebound tenderness and muscle tension. Liver and spleen not touched, can knock and mobility dullness. Maternity: vaginal patency, dome full, smooth cervix, a significant shake pain, uterus and attachment check unclear. Yin was milky secretions less. Blood tests: Hb75g / L, RBC2.6 × 10 ~ (12) / L, WBC1.3 × 10 ~ 9/L, N65%, L35%. Admission diagnosis: ectopic pregnancy, hemorrhagic shock. Immediately under epidural anesthesia to carry out ipsilateral attachment resection. Surgery see the peritoneal was purple-blue, with needle injection 21 needle aspiration of intra-abdominal blood 1300ml back,