论文部分内容阅读
患者女,40岁。因中上腹剧痛伴高热3天在外院对症治疗无效而来诊。查体:T39.8℃,BP10/6kPa。呼吸促,烦躁,颜面苍白,四肢末梢发凉。心率120次/min,律齐,心音低钝。腹部呈板状,中上腹压痛明显,脐周与右上腹深压痛尤甚,反跳痛、莫菲氏征均(+)。其余未发现异常。初诊为感染性休克、急性胰腺炎、急性胆囊炎。入院后,即给予纠正休克、抗感染等对症处理。10小时后血压升至14.5/9.5kPa,腹痛减轻。次日腹部B超示胰头、胰体明显水肿、增大,胆囊壁增厚、粗糙。
Female patient, 40 years old. Due to middle-upper abdomen severe pain accompanied by fever for 3 days outside the symptomatic treatment invalid visit. Physical examination: T39.8 ℃, BP10 / 6kPa. Breathing, irritability, pale face, limbs, cold hair. Heart rate 120 beats / min, law Qi, low heart sound blunt. Abdominal plate, tenderness in the middle and lower abdomen, umbilical cord and right upper quadrant deep tenderness, rebound pain, Murphy’s sign (+). The rest did not find abnormalities. Newly diagnosed as septic shock, acute pancreatitis, acute cholecystitis. After admission, that is given to correct shock, anti-infection and other symptomatic treatment. After 10 hours the blood pressure rose to 14.5 / 9.5kPa, reduce abdominal pain. Abdominal B ultrasound show pancreatic head the next day, pancreatic body significantly edema, increased gallbladder wall thickening, rough.