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1 案例资料 某男,28岁,农民。某日晚10时许被他人用水果刀刺伤左背部,约1h后到医院就诊。查体:神清,急性痛苦病容,脸色苍白,呼吸26次/min,血压12/8 kPa,脉搏80次/min,左背第五、六肋间有一2×0.8cm的横行皮肤裂口,活动性出血,左肺呼吸音减弱,其下界有少许浊音,右肺正常。诊断:左背部刺创;左侧血气胸。给予清创缝合。次日上午9时许入院查体:神志尚清,重度失血病容,呼吸急促,右肺呼吸音粗,左肺未闻及呼吸音,其下界呈实音或浊音,背部创口渗血。诊断:左侧血气胸;失血性休克。立即在局麻下行左胸腔闭式引流术,6h内共引出鲜血约5000ml及少量气体,期间患者转为浅昏迷状态,血压在13/8～8/4kPa范围内波动,
1 case information a male, 28 years old, farmer. 10 o’clock one night was stabbed by someone with a fruit knife left back, about 1h to the hospital. Physical examination: Shen Qing, acute pain and sick, pale, breathing 26 times / min, blood pressure 12/8 kPa, pulse 80 beats / min, left back of the fifth, six intercostals have a 2 × 0.8cm transverse skin rips, activities Bleeding, left lung breath sounds weakened, the lower bound a little dull sound, right lung normal. Diagnosis: left back stab wounds; left hemothorax. Give debridement and suture. The next morning at 9 am admitted to the hospital: conscious Shangqing severe hemorrhagic disease, shortness of breath, right lung breath sounds crude, left lungs did not smell and breath sounds, the lower boundary was solid or dull, back wound bleeding. Diagnosis: left hemothorax; hemorrhagic shock. Immediately under local anesthesia left thoracic closure drainage, a total of 6h lead to about 5000ml blood and a small amount of gas, during which the patient turned shallow coma, blood pressure fluctuations in the range of 13/8 ~ 8 / 4kPa,