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例1 女,40岁,3d反复呕血4次,约2000ml。以上消化道大出血急诊收住。查体:T36℃,P120次/min,BP9/5kPa。神志模糊,面色苍白,四肢湿冷,脉搏细速,腹平坦,剑突下深压痛,肠鸣音活跃。血常规:Hb81g/L,RBC2.75×10~(12)/L,WBC5.2℃×10~9/L,L0.72,N0.28。拟诊:十二指肠球部溃疡出血。在持续硬膜外麻醉下行剖腹探查:胃腔及肠腔内有大量积血,胃后壁距贲门约10cm处有一核桃大小的肿块。切开胃前壁见肿瘤中央部有1cm长裂隙,深约0.5cm,粘膜有散
Example 1 Female, 40 years old, 3d repeated vomiting 4 times, about 2000ml. The above gastrointestinal bleeding was congested in emergency. Physical examination: T36°C, P120 beats/min, BP9/5kPa. Confused mind, pale, cold limbs, rapid pulse, flat belly, deep thoracic tenderness, bowel sounds active. Blood routine: Hb 81g/L, RBC 2.75×10 12/L, WBC 5.2°C×10~9/L, L 0.72, N 0.28. To diagnose: hemorrhage of duodenal ulcer. In the continuous epidural anesthesia, laparotomy is performed: there is a large amount of blood in the stomach cavity and in the intestine, and there is a walnut-sized lump about 10 cm from the posterior wall of the stomach. Cut the anterior wall of the appetizer and see a 1cm long fissure in the central part of the tumor. The depth is about 0.5cm. The mucosa is scattered.