论文部分内容阅读
患者,女,80岁,因腹痛、呕吐、腹泻3天,于1998年8月21日入院.3天前的下午进食面条后出现腹痛,呈持续性绞痛,阵发性加剧.起初以上腹部及脐周为甚,逐渐蔓延至全腹,且以左侧为甚,平卧和进食时腹痛加剧,伴恶心并呕吐胃内容物1次,非喷射状,无夹胆汁及血性物,就诊当地诊所,按“急性胃肠炎”治疗,腹痛仍无缓解,当天晚上出现腹泻10余次,每次量约30～40ml,先为淡黄色稀水样便,后转为含暗红色样便,仍在当地诊所治疗,但诸症状无缓解,遂就诊我院.门诊拟“急性胃肠炎”收住院.既往素健,否认药物及食物过敏史.查体:T37.3℃,P92次/分,R20次/分,BP16/10.5kPa,急性痛苦病容,端坐体位,心肺无异常体征,腹部平坦,较软,全腹轻压痛,无反跳痛,未触及明显包块,肝、脾未触及,肠鸣音约7次/分.血常规:Hb112g/L,WBC15.3×10~9/L,Sg0.876,L0.124.EKG心率101次/分.ST-T未见明显异常,低电压.胸腹X线透视,心肺正常,双膈下未见游离气体,结肠积气并中度扩张,左侧结肠见3～4个梯状肠腔液平,提示:低位不全肠梗阻,大便常规:粘液(+),脓球(+),OB(++).尿常规:蛋白(+++).
The patient, female, 80 years old, was admitted to the hospital on August 21, 1998 due to abdominal pain, vomiting and diarrhea and was admitted to the hospital on the afternoon of August 21, 1998. Abdominal pain, persistent colic and paroxysmal aggravation were observed after eating noodles three days earlier. And umbilical weeks, and gradually spread to the whole abdomen, and to the left is even worse, supine and abdominal pain aggravated, with nausea and vomiting stomach contents 1, non-jet-like, without bile and bloody, visit the local Clinic, according to the “acute gastroenteritis” treatment, abdominal pain still no relief, the same night more than 10 times diarrhea, each volume of about 30 ~ 40ml, first light yellow watery stools, then turned to dark red like stools, Still in the local clinic for treatment, but the symptoms did not ease, then visit our hospital.Ping out to be “acute gastroenteritis” admitted to hospital.Previous prime, denied the history of drug and food allergy.Check the body: T37.3 ℃, P92 times / Points, R20 beats / min, BP16 / 10.5kPa, acute pain and sickness, sitting position, no abnormal signs of heart and lungs, flat belly, soft, full tender mild tenderness, no rebound tenderness, no palpable mass, liver, spleen No touch, bowel sounds about 7 times / min.Hydrogram: Hb112g / L, WBC15.3 × 10 ~ 9 / L, Sg0.876, L0.124.EKG heart rate 101 beats / min.ST-T no obvious Abnormal, low voltage. X-ray chest and abdomen, heart Normal, no gas under the diaphragm, colon gas and moderate expansion, see the left colon 3 to 4 ladder-shaped intestinal cavity level, suggesting: low intestinal obstruction, stool routine: mucus (+), pus ball (+), OB (++). Urine: Protein (+++).