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患女,23岁。头胎足月顺产1男婴后出现腹痛、腹胀、呕吐10d加重伴发热2d。查体:T38℃,P110次/min,R24次/min,BP10/8kPa。贫血外观,心肺听诊除节律快外无明显异常,腹膨隆,左上腹压痛反跳痛明显,移动性浊音阳性,肠鸣音无。B超示腹腔积液。腹穿淡黄混浊液体。血化验:白细胞2.73×10~9/L,红细胞2.3×10~(12)/L,血红蛋白66g/L,红细胞压积0.276,血小板400×10~9/L,血沉300mm/h。剖腹见距屈氏韧带10cm始空肠全变黑无蠕动,对刺激无反应,系膜血管无搏动,经吸氧、热敷、双夫卡因封闭均无效,切除坏死肠管约3m,行空回肠Ⅰ期吻合,系膜断面血管
Female, 23 years old. Abdominal pain, abdominal distension and vomiting intensified with fever for 2 days. Physical examination: T38 ℃, P110 times / min, R24 times / min, BP10 / 8kPa. Anemia appearance, cardiopulmonary auscultation in addition to no significant abnormal rhythm abnormalities, abdominal bulging, left upper quadrant tenderness and rebound tenderness was significant, mobility dullness positive, no bowel sounds. B ultrasound showed ascites. Abdomen wear yellowish cloudy liquid. Blood tests: leukocyte 2.73 × 10 ~ 9 / L, erythrocyte 2.3 × 10 ~ (12) / L, hemoglobin 66g / L, hematocrit 0.276, platelet 400 × 10 ~ 9 / L, erythrocyte sedimentation rate 300mm / h. Caesarean section to see from the ligament of Tui ligament 10cm start of the whole jejunum no blackening of the peristalsis, no stimulation of the stimulation, no pulse of mesangial vessels, oxygen, heat, closed double-cocaine ineffective, removal of necrotic bowel about 3m, empty ileum Ⅰ Period anastomosis, mesangial blood vessels