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男患,5岁。因顽固性呕吐,伴头痛、腹痛、酱油色便5天,面黄,精神极度不振2天入院。查体:体温37.4℃,脉搏120次/分,血压100/60mmHg,精神萎靡,巩膜、皮肤黄染,面部、跟周可见针尖样出血点。口唇苍白,心肺无异常,腹软,肝剑下3.5cm,肋下4.0cm,脾未及,双下肢无浮肿。实验室检查:血红蛋白35g/L,红细胞1.05×10~(12)/L,白细胞36×10~9/L,中幼粒0.04,晚幼粒0.10,杆状粒0.14,分叶粒0.52,晚幼红0.02,中幼红0.02。成熟红细胞大小不等,形态不规则,淡染,嗜中性粒细胞胞浆中毒颗粒、空泡(+),网织红细胞0.45。血小板62×10~9/L。骨髓象呈
Male suffering, 5 years old. Due to intractable vomiting, with headache, abdominal pain, soy sauce color will be 5 days, face yellow, extremely depressed spirit 2 days admission. Physical examination: body temperature 37.4 ℃, pulse 120 beats / min, blood pressure 100 / 60mmHg, apathetic, sclera, yellow skin, face, with the tip of the week can be seen bleeding point. Pale lips, no abnormal heart and lungs, abdominal soft, liver 3.5cm under the sword, under the ribs 4.0cm, spleen and the lower limbs without swelling. Laboratory tests: Hemoglobin 35g / L, erythrocytes 1.05 × 10-12 / L, white blood cells 36 × 10 ~ 9 / L, medium and small grains 0.04, late seed 0.10, rod-shaped grain 0.14, Young red 0.02, young red 0.02. Mature red blood cells ranging in size, irregular shape, light staining, neutrophil cytoplasmic poisoning particles, vacuoles (+), reticulocytes 0.45. Platelets 62 × 10 ~ 9 / L. Bone marrow was like