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例1患者女,24岁,因持续性上腹痛2h,晕厥30min入院。患者突发上腹部持续剧痛,向右肩放射,逐感腹痛范围增大,以右侧为著。2h后感觉口渴,心悸。查体:T38℃,120次/分,BP80/60mmHg(1mmHg=0.133kPa)。神志清楚,烦躁,体质瘦弱,体型矮小,浅表淋巴结未及。脸色苍白,呼吸急促,心肺(-)。腹部饱满,无腹壁静脉怒张,右下胸及上腹部明显压痛,板状腹,全腹压痛、反跳痛,以右上腹最著,肝上界位于右锁骨中线第5肋间,肝下界位于右锁骨中线肋下约6cm。腹部叩诊实音,移动性浊音(+)。肠鸣音弱。
Example 1 Female patient, 24 years old, due to persistent upper abdominal pain 2h, syncope 30min admission. Sudden pain in patients with sudden upper abdomen, radiating to the right shoulder, abdominal pain by the range of increased sensitivity to the right side. 2h after feeling thirsty, palpitations. Examination: T38 ℃, 120 beats / min, BP80 / 60mmHg (1mmHg = 0.133kPa). Conscious, irritable, thin physique, short body, superficial lymph nodes. Pale, shortness of breath, cardiopulmonary (-). Abdominal fullness, no abdominal wall rash, right lower chest and upper abdomen was tenderness, abdominal plate, abdominal tenderness, rebound tenderness to the right upper quadrant of the most, the upper liver is located in the middle of the right subclavian midline 5 intercostal space, the lower liver Located in the right clavicle under the ribs about 6cm. Percussion abdominal real voice, mobility dullness (+). Bowel sounds weak.