患者34岁,孕_2产_1。因孕足月阵发下腹痛伴腹胀呕吐20h,于1998年1月27日急诊入院,体检:心率90次/mim,血压14/10kPa,心肺正常,上腹胀气明显,可见胃型,右下腹压痛(+)。妇检:宫底及胎位因腹胀而查不清,胎心130次/min,较弱,宫缩:20～30s/2～3min,宫口1.5cm。宫颈轻度水肿,先露头,棘下1.5cm,胎膜存。入院后胎心监护示胎心呈“正弦波”型,予静脉三联(10％葡萄糖20ml+维生素C 0.5g+地塞米松5mg)及5％碳酸氢钠100ml,胃肠减压,人工破膜(羊水Ⅱ°),产程进展快,2h后拔露,胎心消失,35min后顺娩一死婴,产后出血不多,1h产妇主诉心慌,查体:心率170次/min血压测不到,下腹压痛(+),反跳痛(+),肠鸣音低,宫腔探查:宫腔完整,宫缩佳。急查血常规;Hb 143g/L,WBC 2.61×10~9/L,N 0.87,查血淀粉酶:63 μ/dL。追问病史:患者已肛门停止排气1d,急请外科会诊,腹穿抽出血性液,镜检:RBC(卌),WBC(+)。诊断:肠梗阻,肠坏死,中毒性休克。转外科全麻下行剖腹探查术,术中见腹腔血性渗液约3500ml,小肠系膜扭转260°,回盲部20cm,以上 Patient 34 years old, pregnant _2 _1. Due to pregnancy full moon burst with abdominal pain accompanied by abdominal distension and vomiting 20h, January 27, 1998 emergency admission, physical examination: heart rate 90 beats / mim, blood pressure 14 / 10kPa, normal heart and lungs, abdominal flatulence evident gastric type, right lower quadrant Tenderness (+). Fetal examination: Palace and fetal position due to bloating and unclear, fetal heart 130 times / min, weaker, contractions: 20 ~ 30s / 2 ~ 3min, cervix 1.5cm. Cervical mild edema, first outcrop, spine 1.5cm, fetal membranes. Fetal heart rate after admission showed fetal heart rate was “sine wave” type, to the triple triple (10% glucose 20mg + vitamin C 0.5g + dexamethasone 5mg) and 5% sodium bicarbonate 100ml, gastrointestinal decompression, artificial rupture of membranes Ⅱ °), fast progress of labor, pull out after 2h, fetal heart disappeared, 35min after delivery of a dead baby, postpartum hemorrhage is not much, 1h maternal complain of palpitation, physical examination: heart rate 170 beats / min blood pressure can not be measured, +), Rebound tenderness (+), low bowel sounds, uterine exploration: uterine integrity, contractions good. Routine blood routine; Hb 143g / L, WBC 2.61 × 10 ~ 9 / L, N 0.87, check blood amylase: 63 μ / dL. Medical history: The patient had an anus to stop bleeding 1d, urgent surgery consultation, abdomen pumping out bloody fluid, microscopic examination: RBC (卌), WBC (+). Diagnosis: intestinal obstruction, intestinal necrosis, toxic shock. Go to the laparotomy under general anesthesia surgery, see the intra-abdominal bloody exudate about 3500ml, small intestine to reverse 260 °, ileocecal 20cm, above