一、病例介绍患者女,32岁。因停经4个月,下腹痛1天于1989年9月5日入院。平时月经正常末次月经4月20日。停经1~+个月时出现恶心、呕吐等症状。9月4日下午洗衣后觉左下腹疼痛,阵发性加重,向腰腿部扩散。伴头晕、呕吐一次,为胃内容物。无阴道流血。6年前患过“肝炎”,已治愈。8年前生产一次,7年前人流一次,未避孕。检查:体温36.7℃,呼吸18次/min,脉搏80/min血压14/10kPa,一般情况良好,心肺(-)。下腹膨隆,无肌紧张,无压痛及反跳痛。肝、脾未触及。宫底脐下两指,有宫缩,胎心140次/min。实验室检查:白细胞11.2×10~9/L,红细胞2.5×10~(12)/L,血色素73g/L,中性0.89。B型超声探测:宫内单活胎,胎儿大小符合孕周。初步诊断:①妊娠18周,晚 First, the case description Female patient, 32 years old. Due to menopause 4 months, one day of lower abdominal pain was admitted on September 5, 1989. Normal menstruation usually the last menstrual April 20. Menopause 1 ~ + months nausea, vomiting and other symptoms. After washing on the afternoon of September 4 left lower quadrant pain, paroxysmal aggravating, spread to waist and legs. With dizziness, vomiting once, for the stomach contents. No vaginal bleeding. Six years ago had “hepatitis”, has been cured. Produced 8 years ago, abortion 7 years ago, not contraception. Check: body temperature 36.7 ℃, breathing 18 times / min, pulse 80 / min blood pressure 14 / 10kPa, generally good, cardiorespiratory (-). Abdominal bulging, no muscle tension, no tenderness and rebound tenderness. Liver, spleen not touched. Palace under the umbilical two fingers, there are contractions, fetal heart rate 140 times / min. Laboratory tests: white blood cells 11.2 × 10 ~ 9 / L, red blood cells 2.5 × 10 ~ (12) / L, hemoglobin 73g / L, neutral 0.89. B-type ultrasound detection: intrauterine single live fetus, fetal size in line with gestational age. Preliminary diagnosis: ① 18 weeks of pregnancy, late