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例1 患女,21岁。因腹胀、尿黄半月,高热、头晕、鼻出血5d入院。查体:急性热病容,面色苍白,精神萎靡,皮肤、巩膜黄染。全身皮肤可见散在出血点,浅表淋巴结不大。心、肺无异常,肝脏右肋下约2cm,质软、压痛,脾未触及,肝区叩击痛阳性。实验室检查:血常规:RBC1.45×10~(12)/L,Hb47g/L,WBC3.O×10~9/L,PC50×10~9/L,Ret0.0015。肝功:BIL76μmol/L、IB38μmol/L,ALT218U,抗HAV-IgM阳性。骨髓检查示:粒系及红系增生低下,原始缺无,仅见个别巨核细胞,血小板偶见。诊断:急性黄疸型甲型肝炎并发再生障碍性贫血。给予清开灵、左旋咪唑、丙酸睾丸酮及反复多次输血治疗1月无效,自动出院,3个月后死亡。
Example 1 suffering from women, 21 years old. Due to abdominal distension, yellow urine half a month, fever, dizziness, epistaxis 5d admission. Physical examination: acute fever, pale, apathetic, skin, sclera yellow dye. Whole body visible scattered blood spots, superficial lymph nodes. Heart, lung no abnormalities, the right rib about 2cm under the liver, soft, tender, spleen not touched, liver percussion pain positive. Laboratory tests: blood: RBC1.45 × 10 ~ (12) / L, Hb47g / L, WBC3.O × 10 ~ 9/L, PC50 × 10 ~ 9/L, Ret0.0015. Liver function: BIL76μmol / L, IB38μmol / L, ALT218U, anti-HAV-IgM positive. Bone marrow examination showed: myeloid and erythroid hyperplasia, the original lack of, only to see individual megakaryocytes, occasionally platelets. Diagnosis: Acute jaundice hepatitis A complicated with aplastic anemia. Give Qing Kai Ling, levamisole, testosterone propionate and repeated transfusion of blood in January invalid, discharged automatically, died after 3 months.