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例1,女,35岁。主诉发热、头痛、腰痛5天,少尿2天。既往体健。病程第五日到当地卫生院就诊。当时T40℃,血压测不出,全腹压痛。阴道后穹隆部穿刺抽到淡红色液体。拟诊“宫外孕破裂”行剖腹术,术中见腹腔少量血性渗液,肾脏肿胀。余无异常发现。术中切口渗血严重,经抗休克治疗后拟诊“发热待查,感染性休克”转本院。体检:T36.5℃,P104次/分,R30次/分,BP13/9kPa。神志清,呼吸急促,眼球结膜充血水肿,上腭及两腋下散在针尖状出血点,两肺呼吸音粗,心率104次/分,律齐,无杂音,肾区叩痛。实验室检查:尿蛋白(?),Hb91g/L,WBC40.1×10~9/L,N0.62,L0.38,BPC38×10~9/L,查见异淋细胞。BuN20.35mmol/L,Cr619μmol/L,CO_2—CP14mmol/L,EHFV-Ab 阳性。诊断:流行性出血热(EHF)少尿期。予液体疗法为主的综合治疗、疗
Example 1, female, 35 years old. Chief complaint fever, headache, back pain 5 days, oliguria 2 days. Past physical health. The fifth day to the local hospital for treatment. At that time T40 ℃, blood pressure can not be measured, the whole abdominal tenderness. After vaginal vault puncture pumped pale pink liquid. The proposed diagnosis of “ectopic pregnancy rupture,” laparotomy, intraoperative see a small amount of bloody exudate, swelling of the kidneys. I found no abnormalities. Intraoperative incision severe bleeding, anti-shock treatment by the proposed diagnosis of “fever to be investigated, septic shock” to the hospital. Physical examination: T36.5 ℃, P104 times / min, R30 beats / min, BP13 / 9kPa. Consciousness, shortness of breath, conjunctival hyperemia and edema, the palate and the two armpits scattered needle-like bleeding point, the two lungs breath sounds coarse, heart rate 104 beats / min, law Qi, no noise, kidney area percussion. Laboratory tests: urine protein (?), Hb91g / L, WBC40.1 × 10 ~ 9 / L, N0.62, L0.38, BPC38 × 10 ~ 9 / L, see the different lymphocytes. BuN20.35mmol / L, Cr619μmol / L, CO_2-CP14mmol / L, EHFV-Ab positive. Diagnosis: Epidemic hemorrhagic fever (EHF) oliguria. To liquid therapy-based comprehensive treatment, treatment