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患者,38岁,孕3产2,因停经4个月,剧烈腹痛8小时急诊入院。检查:BP30/20,P150,R48,面色苍白,烦燥不安,呼吸急促,心音低钝,腹部高度膨隆,全腹压痛反跳痛,宫底触及不清,移动性浊音阴性。内诊:子宫妊娠50天大小,左上方可触及一境界不清包块。腹部穿刺抽出不凝血液。拟诊:输卵管间质部妊娠破裂,失血性休克。患者在行剖腹探查术前已呈深度休克,血压为0,脉搏测不到,心跳停止,呼吸4次/分,瞳孔散大。经加压输液,胸外心脏按摩及人工呼吸,20分钟后,BP40/20,心率54次/分。术中探查时发现腹腔内有血液300ml,子宫位于右测,如妊娠50天左右,左上方见一残角子宫,其上方有8×6×4
Patient, 38 years old, 3 pregnant with 2, due to menopause 4 months, severe abdominal pain 8 hours emergency admission. Check: BP30 / 20, P150, R48, pale, irritable, shortness of breath, low heart sound dull, bulging abdomen, abdominal tenderness rebound tenderness, palace fundus touch unclear, shifting dullness negative. Internal consultation: Uterine pregnancy, 50 days in size, the top left can touch an unclear mass. Abdominal puncture pump out non-condensable blood. Diagnosis: tubal pregnancy rupture, hemorrhagic shock. Patients undergoing laparotomy preoperative deep shock, blood pressure was 0, the pulse can not be measured, stop the heartbeat, breathing 4 beats / min, mydriasis. The pressure infusion, chest and heart massage and artificial respiration, 20 minutes later, BP40 / 20, heart rate 54 beats / min. Intraoperative exploration found that 300ml of blood in the abdominal cavity, the uterus is located in the right test, such as about 50 days of pregnancy, the upper left corner to see a rudimentary horn uterus, the top of which 8 × 6 × 4