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病人男,30岁。入院前1小时不慎从8米高处坠落,左半身横插在围墙防盗网的九枝螺纹钢上。因前后、两侧、会阴部均插有钢筋,患者不能坐、平卧及侧卧。门诊以创伤性休克及胸、腹、会阴部贯通伤伴钢筋残留和胸腹内脏多器官损伤收入院。查体:Bp 9.0/5.0kPa。烦躁不安,手足湿冷,脉搏细速,呼吸急促,左侧肺呼吸音低,可闻及湿性罗音。全腹肌紧张、压痛反跳痛。肠鸣音消失。左胸部两枝螺纹钢由第五肋腋前线及腋中线分别向上及向下斜插入胸腔。左腰背部有两枝螺纹钢刺入腹腔,其中一枝由右季肋部穿出。左髋处两枝钢筋向上斜插腹腔。会阴部两枝钢筋一枝从右腹股沟处穿出。另一枝刺入盆腔;最下一枝钢筋由右大
Male patient, 30 years old. 1 hour before admission, accidentally fell from an altitude of 8 meters, the left half of the cross inserted in the fence anti-theft network of nine rebar. Because of the front and rear, both sides of the perineum were inserted reinforcement, the patient can not sit, supine and lateral. Outpatient traumatic shock and thorax, abdomen, perineum through injuries with steel residue and pleural and abdominal organs multiple organ damage hospital. Physical examination: Bp 9.0 / 5.0kPa. Irritability, cold hands and feet, pulse fine speed, shortness of breath, left lung breath sounds low, can be heard and wet rales. All abdominal muscle tension, tenderness rebound tenderness. Bowel sounds disappear. The left chest two branches of steel from the fifth rib axillary line and the axillary line oblique upward and downward, respectively, into the chest. Left and back of the two threaded steel piercing the abdominal cavity, one of the ribs pierced by the right quarter. Left hip at the two oblique oblique inserted abdominal cavity. Perineal two branches of a stick out from the right groin. Another piercing the pelvic cavity; the next one from the right big bar