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1 病历摘要患者26岁,住院号40732,因妊娠28周,双下肢水肿2个月,呼吸困难4天,加重1天,于1991年6月14日入院。既往体健。孕3产2。查体:T36℃,P126次/分,R40次/分,Bp24/16kPa,精神萎糜,四肢湿冷,由人扶坐,呼吸急促,颜面苍白、水肿、唇绀、巩膜无黄染,浅表淋巴结不肿大,甲状腺不大。两肺满布湿罗音。心界向左扩大,心率126次/分,律齐,心音有力,未闻病理性杂音。腹膨隆,肝脾触诊不满意。宫底脐上二指,胎心听不清,双下肢明显水肿。ECG为窦性心动过速,V_5T波倒置。尿蛋白(++++)。诊断:①孕3产2,妊娠28周,宫内死胎;②妊高征合并急性肺水肿。立即给
1 medical records summary The patient was 26 years old, hospital number 40732, due to 28 weeks of gestation, edema of both lower extremities for 2 months, four days of dyspnea, aggravating one day, on June 14, 1991 admission. Past physical health. Pregnancy 3 2. Examination: T36 ℃, P126 times / min, R40 beats / min, Bp24 / 16kPa, spiritual wilt, limbs cold and cold, by the people sitting, shortness of breath, pale, edema, cyanosis, sclera no yellow dye, superficial Lymph nodes are not swollen, thyroid is not large. Two lungs full of wet rales. Heart to the left to expand, heart rate 126 beats / min, Law Qi, powerful heart sounds, no pathological murmurs heard. Abdominal bulging, liver and spleen palpation are not satisfied. Palace umbilical second finger, fetal heart not clear, double edema of the lower limbs. ECG is sinus tachycardia, V_5T wave inversion. Urinary protein (++++). Diagnosis: ① 3 pregnancy 2, 28 weeks of pregnancy, intrauterine fetal death; ② PIH complicated with acute pulmonary edema. Give it immediately