优先保持和恢复血容量.PPT

FLUID, ELECTROLYTE, AND ACID-BASE DISORDERS 外科水电紊乱与酸碱失衡 Case Report 78 ys, female 平时一般状态良好，自行料理家务，活动 近月来纳差，近5天进食后呕吐，乏力、懒言、嗜睡，入院前一天未排尿 入院Bp 96/58 mmHg, P 106 bpm, R 28 tpm 心肺查体无明显异常；腹部稍隆，未见胃肠型及逆蠕动波，胃区振水音未闻及；肝、胆、脾未触及，全腹未及肿物，无压痛、反跳痛区；膀胱区叩浊，移动性浊音阴性。留置导尿，膀胱潴留尿液3200 ml，导尿后尿量30 ml/hrs。 Case Report (cont) Blood RT Hb 152 g/L RBC 452×1012/L Hct 45.2% WBC 107×109/L N 71% Electrolytes Na 128 mEq/L K 2.8 mEq/L Ca 1.83 mEq/L Cl 87 mEq/L TCO2 32.8 mEq/L Liver Function Alb 28 g/L Glu 26 g/L Others normal Kidney Function BUN 7.1 mg/L Cr 218 mg/L Blood Sugar 4.6 mEq/L Urine RT Density 1.030 KET +++ Others norm