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患者30岁,病历号379669.孕3产1,平素月经正常,末次月经1985年5月13日,停经40~+天时曾有少量阴道出血,无明显早孕反应,于8月16口无诱因突然右下腹剧烈疼痛至晕厥,伴恶心呕吐,肛门坠痛,急诊入院.入院检查:T36.8℃,Bp12/8kPa,R20次/分,P120次/分.右下腹有轻微压痛及反跳痛,移动性浊音阳性.妇科检查:外阴经产型,阴道无血迹,宫颈光滑,着色且软,举痛明显,后穹窿饱满,子宫中位正常大小,软,有漂浮感,右附件区有增厚及明显压痛,未触及包块,左附件区软.化验:尿妊娠免疫反应阳性,血红蛋白90g/L,白细胞9.1×10~9/L.临床诊断:右侧输卵管妊娠破裂;腹腔内出血;失血性贫血。于入院当日在连硬外麻醉下急诊开腹手术,术中
Patient 30 years old, medical record number 379669. Pregnancy and 3 births 1, usually normal menstruation, the last menstrual May 13, 1985, menopause 40 ~ + days had a small amount of vaginal bleeding, no significant response to early pregnancy, no reason in August 16 sudden Right lower abdomen severe pain to syncope, with nausea and vomiting, anal fall, emergency admission. Admission examination: T36.8 ℃, Bp12 / 8kPa, R20 times / min, P120 beats / min. Right lower quadrant with slight tenderness and rebound tenderness, Mobility dullness positive gynecological examination: vaginal production type, vaginal no blood, smooth cervix, coloring and soft, obvious pain, after the fornix full, normal median size of the uterus, soft, floating sense, right attachment area thickening And obvious tenderness, did not touch the mass, the left attachment area is soft.Experiment: Urine pregnancy immune response is positive, hemoglobin 90g / L, WBC 9.1 × 10 ~ 9 / L. Clinical diagnosis: rupture of right tubal pregnancy; intraperitoneal hemorrhage; hemorrhagic anemia. On the day of admission, even under external anesthesia emergency open laparotomy, intraoperative