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长时间在手术室,因室温过低,发生冷凝球蛋白血症,循环血球蛋白异常沉积。本文报告冷凝球蛋白,因肾血管内冷凝沉积,造成急性肾功能衰竭。女性60岁,踝关节间隙性肿痛6个月,伴周身发热(39.5℃),下肢红斑,瘀血点,但无外伤及感染史。体重下降1 6公斤,血沉36毫米/时,血红蛋白11.7克,血小板23万6千,X 光照片:胃上部浸润性病变,胃镜检查:胃皱襞增大,胃粘膜白斑,而行全胃切除术,手术室温度20℃,手术4小时10分,又无特殊保温,回监护病房时体温34.8℃,病理报告:胃组织‘弥漫性分化完全淋巴细胞型淋巴瘤’.萤光免疫观察:单克隆表面有免疫球蛋白 IgM,及K—轻链免疫球蛋白,骨髓检查:‘淋巴瘤’,术
A long time in the operating room, due to low temperature, condensation of hemoglobin, circulating abnormal circulating hemoglobin. This article reports condensation of globulin, due to renal vascular condensation deposition, resulting in acute renal failure. Female 60 years old, intermittent ankle swelling and pain for 6 months, with perinatal fever (39.5 ℃), lower extremity erythema, blood stasis, but no history of trauma and infection. Weight loss 16 kg, erythrocyte sedimentation rate 36 mm / h, hemoglobin 11.7 g, platelets 230 000, X-ray: Upper gastric infiltrates, gastroscopy: gastric folds increased, gastric mucosal leukoplakia, and total gastrectomy , Operating room temperature 20 ℃, 4 hours and 10 hours of surgery, no special heat, the temperature of the back ward 34.8 ℃, pathological report: diffusely differentiated complete lymphoid lymphoma of gastric tissue ’.Fluorescence Immunohistochemistry: Monoclonal The surface of immunoglobulin IgM, and K-light chain immunoglobulin, bone marrow examination: ’Lymphoma’, surgery