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骨髓细胞坏死可见于感染、白血病,放射损伤及镶形细胞病者的尸检中,但生前确诊者为数不多,我们曾遇到L例,现报告如下: 患者赵××,女,46岁,农民,住院号302926。因发热伴腰背部疼痛50天,加重10天于1989年1月11日入院。既往有长期农药接触史。查体:T39.5℃,BP110/60mmHg,神志清,贫血貌,四肢皮肤可见散在瘀点瘀斑,扁桃体不大。颈软,胸骨下段压痛,两肺呼吸音清,心率118次/分,律齐,无杂音。腹软,肝肋下3cm,剑下5cm,脾肋下2cm,质韧有触痛。脊柱明显叩击痛,四肢长骨、肋骨及髋骨有明显压痛。实验室检查:Hb4.5g%,WBC 120,000/mm~3,N12%,原+早幼淋巴细胞占88%,可见有核红细胞,网织红细胞0.1%,血小板2.9万/mm~3,尿蛋白(+),镜检脓细胞少许。大便潜血(+)。肝肾功能正常,血培养阴性。心电图示窦速,骨盆X线平片无
Bone marrow cell necrosis can be seen in the autopsy of infection, leukemia, radiation injury and in-cell disease, but few were diagnosed before their death. We have encountered L cases and are reported as follows: Zhao XX, F, 46, Peasant, hospital number 302926. Due to fever with low back pain for 50 days, increased 10 days in January 11, 1989 admission. Past history of long-term exposure to pesticides. Physical examination: T39.5 ℃, BP110 / 60mmHg, clear mind, anemia appearance, visible limbs scattered petechiae petechiae, tonsil not. Neck soft, tender lower part of the sternum, lung breath sounds clear, heart rate 118 beats / min, law Qi, no noise. Abdomen soft, ribs under the liver 3cm, 5cm under the sword, Spleen ribs 2cm, quality tough tenderness. Significant percussion pain in the spine, limb long bones, ribs and hip have significant tenderness. Laboratory examination: Hb4.5g%, WBC 120,000 / mm ~ 3, N12%, the original + premature young lymphocytes accounted for 88%, visible nucleated erythrocytes, reticulocytes 0.1%, platelets 29000 / mm ~ 3, urinary protein (+), A little pus mirror. Fecal occult blood (+). Liver and kidney function is normal, blood culture negative. Electrocardiogram sinus speed, pelvic X-ray no