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病例摘要患者27岁,农民,住院号23846。宫内孕35周,第一胎。因搬煤后引起腹部疼痛,伴少量阴道出血,在当地医院“输液”后,腹胀4天,未排气排便,转入我院。门诊以“先兆早产”、“肠梗阻”的诊断收入病房。检查:T37℃,P86次/分,R20次/分,Bp120/80mmHg。宫高26cm,腹围97cm,胎先露头,衔接,胎方位LOA。胎心音150次/分,有不规律宫缩。肛查颈管未消失。检验:WBC12.6×10_(?)/L,S0.71,L0.23。治疗:入院后给镇静、止血、保胎治疗。促胎肺成熟用地塞米松5mg,qd,im。患者腹胀难忍行肛管排气,并请外科会诊,诊断为麻痹性肠梗阻,给持续胃肠减压,清洁洗肠,肌注新斯的明。后查电解质Na~+144mmol/L,K~+3.68mmol/L,Cl~-112mmol/L,腹透
Case Summary Patient 27 years old, farmer, hospital number 23846. Intrauterine pregnancy 35 weeks, the first child. Abdominal pain caused by moving the coal, with a small amount of vaginal bleeding in the local hospital “infusion”, bloating 4 days, no defecation, transferred to our hospital. Outpatient diagnosis of “threatened preterm birth”, “intestinal obstruction” Ward. Check: T37 ℃, P86 times / min, R20 times / min, Bp120 / 80mmHg. Palace height 26cm, abdominal circumference 97cm, fetal first outcrop, convergence, fetal position LOA. Fetal heart sound 150 beats / min, there are irregular contractions. Anal check neck did not disappear. Test: WBC12.6 × 10 _ (?) / L, S0.71, L0.23. Treatment: After admission to the sedation, bleeding, miscarriage treatment. Accelerate fetal lung dexamethasone 5mg, qd, im. Patients with abdominal distension line anal canal exhaust, and ask the surgical consultation, diagnosed as paralytic ileus, to sustained gastrointestinal decompression, clean colon hydrotherapy, intramuscular injection of neostigmine. After checking the electrolyte Na ~ 144mmol / L, K ~ + 3.68mmol / L, Cl ~ -112mmol / L, dialysis