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患者男,64岁。以右上腹持续性绞痛,伴寒战,高热,恶心呕吐,黑便,休克,全身黄染,急诊住院。查体:T 39.2℃,P 120次/分,R 25次/分,Bp 9/7kPa。表情淡漠,希氏面容,巩膜轻度黄染,浅表静脉塌陷,口唇轻度发绀,毛细血管充盈时间延长大于两秒,手足湿冷。心肺听诊无异常,心电图无异常。腹部膨隆,未见肠型与蠕动波,全腹腹膜炎体征,以右上腹为重,未触及包块,移动浊音阳性,肠鸣音弱。腹穿获棕褐色血性液体,化验淀粉醺941U。Hb 147g/L,WBC 15.3×10~9/L,N 0.82。K~+3.5mmol/L,Na~+129mmol/L,C1~-106mmol/L,CO_2CP 14mmol/L,BUN 10.9mmol/L,
Patient male, 64 years old. To the right upper quadrant of persistent colic, chills, fever, nausea, vomiting, melena, shock, body yellow dye, emergency hospitalization. Examination: T 39.2 ℃, P 120 beats / min, R 25 beats / min, Bp 9 / 7kPa. Indifferent expression, His face, scleral mild yellow dye, superficial vein collapse, mild cyanosis lips, capillary filling longer than two seconds, cold hands and feet. Cardiopulmonary auscultation without exception, no abnormal ECG. Abdominal bulging, no intestinal and peristaltic wave, all signs of peritonitis, to the right upper quadrant was heavy, not touched the mass, shifting dullness positive, bowel sounds weak. Abdominal wear was sebic bloody liquid, test starch 醺 941U. Hb 147 g / L, WBC 15.3 × 10 9 / L, N 0.82. K ~ + 3.5mmol / L, Na ~ + 129mmol / L, Cl ~ -106mmol / L, CO_2CP 14mmol / L, BUN 10.9mmol /