患者，男性，60岁，腹痛伴发热和黄疸3天。烦躁，有上腹压痛、反跳痛和肌紧张不明显。血常规检查WBC3.5x109/L,NO.85,血尿淀粉酶正常。经抗菌治疗第2天症状不缓解，患者神志淡漠，血压75/60mmHg,尿量减少。此时患者合并有

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