内镜成功治疗鱼刺致小肠穿孔一例
Chinese Journal of Clinicians (Electronic Edition)（2022）
Abstract
患者,吴某,男,59岁,因"突发腹痛伴呕吐、肛门停止排便排气1d"入院.腹痛呈持续性全腹胀痛,阵发性加重.既往30年前因"急性阑尾炎"行阑尾切除术.体格检查:体温36.8℃,脉搏96次/min,呼吸20次/min,血压 110/70 mmHg(1 mmHg=0.133 kPa);神志清楚,急性面容,强迫体位;心肺听诊无异常;腹肌紧张,全腹压痛,以右下腹及中下腹部显著,反跳痛阳性,肝脾肋下未及,Murphy征阴性,肝浊音界存在,肝肾区无叩击痛,腹水征阴性,肠鸣音减弱,双下肢无水肿.血气分析:pH 值 7.47,动脉血氧分压(arterial partial pressure of oxygen,PaO2)81 mmHg,动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO2)35 mmHg,碳酸氢根(HCO3)25.5 mmol/L,血糖 6.3mmol/L.
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