病历摘要冯××,男,64岁,工人,住院号8296。患者饱餐后突发上腹钝痛10天,伴恶心,未吐,不思饮食。5天来发热,昏哑,全腹胀满,停止排便排气,卧床不起,于1978年2月26日急诊入院。平日健康,参加重体力劳动。体检:体温38.6℃,脉搏140次/分,呼吸32次/分,血压测不出。神志淡漠,皮肤湿凉,面色苍白,巩膜微黄(灯光下)。颈软,呼吸深快,第一心音减弱。腹膨隆,腹式呼吸受限,未见肠型及蠕动波,全腹有广泛性压痛,反跳痛及肌紧张,右上腹尤剧,未扪及包块,全腹鼓音,肝浊音界存在,可叩及移动性浊音,肠鸣音消失。化验:血红蛋白11克%,红细胞380万/立方毫米,白细胞24,400/立方毫米,中性粒细胞88%,非蛋白氮41毫克%,二氧化碳结合力36容积%,钾11毫克%,钠310.4毫克%,钙8.5毫克%。尿:黄红色,混浊,蛋白(++),红细胞可见,白细胞少见,颗粒管型(+),透明管型少许,三胆弱阳性。肝功:黄疸指数16单位,麝香草酚浊度1单位,絮状阴性,硫 Medical record summary Feng × ×, male, 64 years old, worker, hospital number 8296. Sudden abdomen pain suddenly after the patient ate 10 days, with nausea, no spit, do not think diet. 5 days to fever, dull, full belly full, stop defecation exhaust, bedridden, in February 26, 1978 emergency room admission. Healthy on weekdays, to participate in heavy manual labor. Physical examination: body temperature 38.6 ℃, pulse 140 beats / min, breathing 32 beats / min, blood pressure can not be measured. Conscious indifferent, wet skin, pale, scleral yellow (light). Soft neck, deep breathing, the first heart sound weakened. Abdominal bulge, abdominal breathing is limited, no intestinal and peristaltic waves, the whole abdomen with extensive tenderness, rebound tenderness and muscle tension, especially the right upper quadrant, no palpable mass, the whole belly drum sound, liver dullness exist , Can knock and mobility dullness, bowel sounds disappear. Assay: hemoglobin 11%, erythrocyte 3.8 million / mm3, leukocytes 24,400 / mm3, neutrophils 88%, non-protein nitrogen 41 mg%, carbon dioxide binding 36%, potassium 11 mg, sodium 310.4 mg% , 8.5 mg of calcium. Urine: yellow-red, turbid, protein (++), red blood cells can be seen, rare white blood cells, granular tube (+), a little transparent tube, three gall weak positive. Liver function: jaundice index 16 units, thymol turbidity 1 unit, flocculent negative, sulfur