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患者女,12岁。因车祸致下腹痛,双下肢活动障碍15分钟送我院急诊科。体格检查:神清合作,全身皮肤未见明显擦伤,腹平,下腹肌紧张,轻压痛;全腹无反跳痛,肝肾区无叩痛,无移动性浊音,肠鸣音减弱。骨科检查:右髋轻度肿胀,骨盆挤压征(+),右髋压痛(+),腹腔穿刺未引出液体,骨盆X线片发现骨盆多发骨折并右股骨颈基底部骨折,收入骨科治疗。入院后除下腹痛外无其它不适。外伤后20小时突然出现胸闷、胸痛,呼吸困难,即予吸氧等对症处理后好转。当时查体:气管右移,心脏左界叩诊鼓音,心尖
Female patient, 12 years old. Due to a car accident caused by abdominal pain, lower extremity movement disorders 15 minutes to our hospital emergency department. Physical examination: Shen Qing cooperation, no obvious skin abrasions, abdominal flat, lower abdominal muscle tension, mild tenderness; the whole abdomen without rebound tenderness, no percussion pain in the liver and kidney area, no movement dullness, bowel sounds weakened. Orthopedic examination: mild swelling of the right hip, pelvic compression (+), right hip tenderness (+), abdominal paracentesis did not lead to fluid, pelvic X-ray found multiple pelvic fractures and right femoral neck fracture, income orthopedic treatment. In addition to abdominal pain after admission without any other discomfort. Twenty hours after trauma suddenly appeared chest tightness, chest pain, dyspnea, that is, to improve oxygen and other symptomatic treatment. At that time physical examination: right tracheal shift, pericardal left percussion drum sound, apical