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1 病历摘要 患者,女性,16岁 3天前突感上腹部疼痛,伴恶心,呕吐,8小时后疼痛迁移至右下腹,伴发热,无寒战,无腰痛,无尿急、尿频、尿痛、血尿。以“急性化脓性阑尾炎”收入我院。 患者于2年前发现右肾结石,2月前在某医院行肾结石取石术,取出结石4枚。 查体:T38.8℃ P102次/分 Bp13/8kPa,神志情,巩膜无黄染,口唇干燥,双肺呼吸音清。心率102次/分,音清,律齐。腹部平坦,右髂腰部有13cm手术疤痕,右下腹肌紧张,伴压痛,反跳痛,全腹未扪到肿块,肝脾无肿大,肠音弱。右肾区压痛(-),叩击痛(±)。血常规:Hb 110g/L,WBC13×10~9/L,N
Patient, female, 16 years old Sudden upper abdominal pain, with nausea and vomiting 3 days earlier, pain migrated to the right lower quadrant after 8 hours with fever, no chills, no back pain, no urgency, frequent urination, hematuria. To “acute suppurative appendicitis” income in our hospital. Two years ago, the patient found a right kidney stone, and a kidney stone lithotomy was performed in a hospital two months ago and four stones were removed. Physical examination: T38.8 ℃ P102 times / min Bp13 / 8kPa, God state of mind, Sclera no yellow dye, dry lips, lung breath sounds clear. Heart rate 102 beats / min, sound clear, law Qi. Abdomen flat, right iliac waist with 13cm surgical scar, right lower quadrant muscle tension, with tenderness, rebound tenderness, the whole abdomen palpable mass, no enlargement of the liver and spleen, weak intestinal sounds. Right kidney area tenderness (-), percussion pain (±). Blood: Hb 110g / L, WBC13 × 10 ~ 9 / L, N.