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患者女,30岁。孕3产1,因停经5月引产后4小时,阴道流血3小时于1999年3月4日急诊入院。患者4小时前在当地诊所眼用米非司酮及米索前列醇加催产素静滴引产。入院查体;血压83/53mmHg,脉搏85次/分,呼吸25次/分,体温37℃。神志清,精神差,面色苍白,心肺听诊无特殊。宫底脐平,下腹压痛。妇检:外阴血染,裂伤,阴道多量凝血块约500ml。宫颈8~7点处裂伤已修补,子宫约孕5~+月大小,压痛,双附件未及,查血红蛋白56g/L。初步诊断;产后出血,失血性休克,软产道裂伤。入院后立即吸氧、快速输血输液抗休克治疗同时行清宫术、宫颈裂伤再修补。术后血压仍不见好转,行CT检查示子宫破裂,腹腔积血。即在全麻下行剖腹探查术,术中见腹膜积血
Female patient, 30 years old. Pregnancy 3 1, due to menopause in May 4 hours after induction of labor, vaginal bleeding 3 hours on March 4, 1999 emergency admission. Patients 4 hours ago in the local clinic ophthalmic mifepristone and misoprostol plus oxytocin intravenous drip. Admission examination; blood pressure 83 / 53mmHg, pulse 85 beats / min, breathing 25 beats / min, temperature 37 ℃. Conscious, poor spirits, pale, cardiopulmonary auscultation no special. Palace umbilical flat, abdominal tenderness. Gynecological examination: vulvarium bloody, laceration, vaginal mass clot about 500ml. Cervical laceration has been repaired at 8 to 7 o’clock, the uterus about 5 ~ + month size, tenderness, double attachment not yet, check the hemoglobin 56g / L. Initial diagnosis; postpartum hemorrhage, hemorrhagic shock, soft birth canal laceration. Oxygen immediately after admission, fast transfusion anti-shock therapy at the same time curettage, cervical laceration and then repair. Postoperative blood pressure is still not improved, line CT examination showed rupture of the uterus, ascites. That underwent laparotomy under general anesthesia, intraoperative see peritoneal hemorrhage