论文部分内容阅读
患者21岁,住院号344469,壮族。因头晕、鼻衄、茶色尿2年余合并妊娠35周,于1990年3月17日入院。化验:血红蛋白18～41g/L,血小板正常,晚幼红细胞0.01。B超示脾大。行骨穿考虑“溶血”,以“溶血合并妊娠8个月”入院。即往无食入蚕豆及药物过敏史。自幼体质差,3～4岁时曾有鼻衄、乏力、浓茶色尿,未经治疗,休息后缓解。月经规则,量中。家族中祖母及父亲有贫血病史,其母及兄妹未作检查。体检:T36℃,P80次/分,8p17/12kPa,营养差,重度贫血貌,皮肤粘膜无黄染,无出血点,双肺呼吸音清,心界向左扩大,心率108次/分,律齐,于心尖部及左第2～3肋间均可闻及Ⅱ级吹风样杂音,不向颈部传导。腹膨隆,脾未触及,肝于右肋下6cm大小,质韧,宫底于剑突下二指,双下肢水肿。产科情况:腹围80cm,宫高30cm,LOA,胎心140次/分,骨盆测量正常范围。B超:胎头双顶径7.6cm,羊水4.3cm,胎盘成熟度Ⅰ级。
Patient 21 years old, hospital number 344469, Zhuang. Due to dizziness, epistaxis, brown urine 2 years more than 35 weeks of pregnancy, in March 17, 1990 admission. Laboratory tests: hemoglobin 18 ~ 41g / L, normal platelets, late erythroblast 0.01. B super show splenomegaly. Line bone wear to consider “hemolysis” to “hemolysis with pregnancy 8 months” admission. That is, no food into the broad beans and drug allergy history. Since childhood, poor health, 3 to 4 years old had epistaxis, fatigue, dark brown tea, untreated, relieved after a rest. Menstruation rules, volume. The family had grandmothers and fathers anemia history, the mother and brother and sister were not examined. Physical examination: T36 ℃, P80 / min, 8p17 / 12kPa, poor nutrition, severe anemia, skin and mucosa without yellow dye, no bleeding points, lung breath sounds clear, heart left to expand, heart rate 108 beats / min, Qi, in the apical and left 2 ~ 3 intercostal can smell and Ⅱ grade hair-like noise, not to the neck conduction. Abdominal bulge, spleen not touched, the size of the liver in the right rib 6cm, quality and toughness, Palace at the bottom of the xiphoid two fingers, lower extremity edema. Obstetric conditions: abdominal circumference 80cm, palace height 30cm, LOA, fetal heart rate 140 beats / min, pelvis measurement normal range. B super: fetal head biparietal diameter 7.6cm, amniotic fluid 4.3cm, placental maturity grade Ⅰ.