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患者,男,12岁,因畏寒发热伴头痛腰痛5天入院,入院前淋雨后起畏寒发热伴头痛、腰痛、全身不适,时有腹隐痛伴恶心,呕吐两次,非喷射性,病后排尿减少,来院前1天仍坚持上学,无外伤史,家住出血热流行区.体检:体温39.4℃,血压16/12kPa,神志清,轻度酒醉貌,两腋下较多出血点,眼睑略肿,结膜充血水肿,咽充血,软腭较多出血点.颈软,心率133次/分,律齐,两肺呼吸音清晰,腹软,肝脾未及,脐周轻压痛,双肾区叩痛明显.神经系统检查正常.辅助检查:血色素117g/L,白细胞26.7×10~9/L,中性0.87,淋巴0.09.异淋0.038,血小板55×10~9/L:尿蛋白(+++).红细胞(+++)、管型(+):血肌酐460.8μmol/L,尿素氮26.21μmol/L,谷丙酶63u/L,EHF-IgM阳性.
Patients, male, 12 years old, due to chills and fever with headache and low back pain 5 days admitted to hospital before admission, chills and fever with headache, lumbago, general malaise, sometimes abdominal pain with nausea and vomiting twice, non-jet, Less urination after the illness, to hospital 1 day still insisted on school, no history of trauma, who live in hemorrhagic fever epidemic area. Physical examination: body temperature 39.4 ℃, blood pressure 16 / 12kPa, clear mind, mild drunk appearance, more bleeding points under both armpits , Eyelid slightly swollen, conjunctival congestion and edema, pharyngeal congestion, bleeding more soft palate. Soft neck, heart rate 133 beats / min, law Qi, both lungs breath sounds clear, abdomen soft, liver and spleen, Kidney area percussion pain was obvious. Nervous system examination was normal. Auxiliary examination: hemoglobin 117g / L, leukocytes 26.7 × 10 ~ 9 / L, neutral 0.87, lymph 0.09. Heterophile 0.038, platelets 55 × 10 ~ 9 / L: urinary protein (+++) .Cell + (+): serum creatinine 460.8μmol / L, urea nitrogen 26.21μmol / L, glutathione 63u / L, EHF-IgM positive.