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患者17岁,1989年10月12日上午因车祸急诊入院。查体:贫血貌,血压9/5 kPa,心率110次/分,律齐,双肺呼吸音正常,下腹部稍隆起,腹肌紧张,有压痛及反跳痛,肝脾肋下未触及,移动性浊音阳性。耻骨联合有压痛。妇科检查:外阴右侧有一8cm×7cm×6cm撕裂伤口,并有活动性出血。予以导尿,见肉眼血尿。初步诊断:①失血性休克,②膀胱破裂,③外阴撕裂伤,④耻骨骨折?立即给以补液、输血及抗感染等治疗,同时清创缝合外阴伤口,然后在外科医生协助下立即剖腹
The patient was 17 years old and admitted to the hospital due to a car accident in the morning of October 12, 1989. Physical examination: anemia appearance, blood pressure 9/5 kPa, heart rate 110 beats / min, law Qi, lungs normal breathing, the lower abdomen slightly elevated, abdominal muscle tension, tenderness and rebound tenderness, Mobility positive. Pubic symphysis have tenderness. Gynecological examination: vulva on the right there is a tear 8cm × 7cm × 6cm wound, and active bleeding. To catheterization, see gross hematuria. Initial diagnosis: ① hemorrhagic shock, ② bladder rupture, ③ genital laceration, ④ pubic fracture? Immediate rehydration, blood transfusion and anti-infective treatment, etc., and debridement genital suture wound, and then with the help of a surgeon immediately cesarean section