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患儿杜××,女,8岁,学生,广东籍。98年8月3日上午9时许,突感腹痛,初期以上腹为主,1小时后疼痛波及全腹呈持续性胀痛,在外院以阑尾炎治疗症状未见好转,发病3小时后到我院。门诊以腹痛待查收住院。查体:T 36.3℃,P 120次/分,R 20次/分,BP 75/53mm Hg,发育正常、营养中等,神清,表情淡漠,检查合作,自动体位,面色苍白,四肢发凉,甲床及脸结膜发白,心肺(一),腹部稍膨隆,未见胃肠型及蠕动波,全腹压痛(+),反跳痛(+),肌紧张(+),尤以下腹部为甚,移动性浊音(+),肠鸣音弱,“B”超示:肝、胆、脾、双肾均未见异常,子宫、附件由于膀胱充盈不佳显示模糊,右下腹见宽约4.8cm液性暗区,左下腹见宽约3.3cm液性暗区。急查血常规:RBC 2.20×10~(12)/L、Hb 53g/L、WBC 7.92×10~9/L、PLT 205×10~9/L、N 0.684急查生化,CO_2CP 20.2mmol/L、K~+ 3.6mmol/L,Na~+ 139mmol/L,心电图示:窦性心动过速。右下腹穿刺:吸
Children Du × ×, female, 8 years old, students, Cantonese. August 3, 1998 at 9 am, sudden sensation of abdominal pain, early to the upper abdomen, 1 hour after the pain spread to the abdomen was persistent pain, appendicitis in the outer hospital did not improve the symptoms, 3 hours after onset to me hospital. Outpatient abdominal pain to be admitted to hospital. Physical examination: T 36.3 ℃, P 120 beats / min, R 20 beats / min, BP 75 / 53mm Hg, normal development, moderate nutrition, clear appearance, indifference, check cooperation, automatic position, pale, A bed and face conjunctiva white, heart and lung (a), the abdomen slightly bulging, no gastrointestinal type and peristaltic waves, full abdominal tenderness (+), rebound tenderness (+), muscle tension (+), especially in the lower abdomen Very, mobility dullness (+), bowel sounds weak, “B ” super show: liver, gallbladder, spleen, both kidneys were not abnormal, uterus, appendix due to poor bladder filling showed fuzzy, right lower quadrant wide About 4.8cm liquid dark area, see the left lower abdomen with a width of about 3.3cm liquid dark area. RBC 2.20 × 10 ~ (12) / L, Hb 53g / L, WBC 7.92 × 10 ~ 9 / L, PLT 205 × 10 ~ 9 / L, , K ~ + 3.6mmol / L, Na ~ + 139mmol / L, ECG shows: sinus tachycardia. Right lower quadrant puncture: suction