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1 临床资料 患者,男性,20岁,以右下腹痛1个月,加重3天为主诉入院,恶心,未吐,无腹泻,无咽痛,发热,测体温38℃。查体:体温38℃,血压16.0/9.7kPa,面色暗黄,心肺未见异常,腹平坦,未见胃肠型及蠕动波,右下腹压痛,反跳痛及肌紧张,移动性浊音阴性,肠鸣音正常,5次/min,胸片是肺结核及右上肺不张,血常规示白细胞12.O×10~9/L,中性90％,尿常规正常,既往半年前,患者自觉乏力,盗汗,未经诊治。目前诊断:①慢性阑尾炎急性发作;②肺结核。 治疗:急性硬膜外麻醉下行阑尾切除术,术中见阑尾增粗,圆锥形,基底部直径2.5cm,与盲肠分界不清,系膜肿胀,
1 Clinical data Patients, men, 20 years old, right lower quadrant pain for 1 month, increased 3 days for the main complaint of admission, nausea, vomiting, no diarrhea, no sore throat, fever, measured body temperature 38 ℃. Examination: body temperature 38 ℃, blood pressure 16.0 / 9.7kPa, dark yellow, no abnormal heart and lungs, flat belly, no gastrointestinal and peristaltic waves, right lower quadrant tenderness, rebound tenderness and muscle tension, Bowel sounds normal, 5 times / min, chest X-ray is a pulmonary tuberculosis and right atelectasis, white blood cells showed 10. O × 10 ~ 9 / L, 90% neutral, normal urine, past six months ago, patients with fatigue , Night sweats, without consultation. The current diagnosis: ① acute exacerbation of chronic appendicitis; ② tuberculosis. Treatment: Acute epidural anesthesia appendectomy appendectomy surgery see the appendage thickening, conical, basal diameter 2.5cm, and cecum demarcation is not clear, the mesangial swelling,