论文部分内容阅读
患者男性,68岁。因突发上腹部疼痛3h入院。疼痛呈撕裂样,持续性,伴不能平卧,呼吸稍困难,并有呕吐胃内容物数次,不伴畏冷、发热、腹泻。患者原有“胃病史”20年。门诊急查白细胞9.8×10~9/L,中性0.78,淋巴0.22,血红蛋白115g/L,以“消化性溃疡穿孔并发腹膜炎”收住外科。体检:T37℃,P84次/min,R24次/min,BP16/11kPa。急性痛苦面容,呻吟,口唇无发绀。颈软,气管居中,胸廓对称,双肺呼吸音增粗,心界无扩大,心率84次/min,律齐,未闻及病理性杂音。腹肌紧张,板样腹,全腹均有压痛、反跳痛,以右上腹明显,肝脾触诊不满意,肠鸣音消失。双下肢无浮肿。
Male patient, 68 years old. Due to sudden upper abdominal pain 3h admission. Pain was tear-like, persistent, with no supine, breathing a little difficult, and vomiting stomach contents several times, not with fear of cold, fever, diarrhea. Patients with “stomach history” for 20 years. Outpatient emergency check white blood cells 9.8 × 10 ~ 9 / L, neutral 0.78, lymph 0.22, hemoglobin 115g / L, “peptic ulcer perforation complicated by peritonitis” to receive surgery. Physical examination: T37 ℃, P84 times / min, R24 times / min, BP16 / 11kPa. Acute pain face, moaning, lips without cyanosis. Neck soft, tracheal center, symmetrical thoracic, lung breath sounds thick, no expansion of the heart, heart rate 84 times / min, law Qi, no smell and pathological murmur. Abdominal tension, plate-like abdomen, the whole abdomen are tenderness, rebound tenderness, obvious to the right upper quadrant, liver and spleen palpation are not satisfied, bowel sounds disappear. No lower extremity edema.