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女,76天,第一胎,孕42周,头盆不称于外院剖宫产术,生后自然啼哭。第二天右侧头顶部发现一1×1cm血肿,给予止血治疗未见增大,住院13天,一般情况好出院(未作血常规检查)。出院后一周头部肿物逐渐增大。曾就诊市某医院门诊拟“头部血肿”,抽取治疗,乏效,血肿逐渐增大,并出现皮下瘀点、瘀斑,进行性面色苍白,再次复诊市某医院拟诊“白血病”。于90年10月22日入本科。体查:T37.5℃,发育营养差,重度贫血貌,神清,倦,呼吸促。唇绀,颜面、躯干可见皮肤瘀点瘀斑,头顶右侧扪及一6×5cm肿物,波动感明显。全身浅表淋巴结触及如绿豆、花生米大,移动。心肺未见异常,腹软,肝右肋下2.5cm,脾左助下3cm,质硬。入院时白细胞数60.0×10~9/L,幼稚细胞0.25,分叶细胞
Female, 76 days, the first child, 42 weeks pregnant, cephalopelvic ectopic pregnancy outside the hospital, natural crying after birth. On the second day, a 1 × 1 cm hematoma was found at the top of the right head. No hemostasis was given to the right head of the head. The patient was hospitalized for 13 days and was generally discharged (without routine blood tests). One week after discharge head tumor gradually increased. Had seen a hospital outpatient clinic in the city to be “head hematoma”, extraction treatment, ineffective, hematoma gradually increased, and subcutaneous petechiae, ecchymosis, progressive pale, again referral city to be diagnosed with a hospital “leukemia.” In October 90, 90 into the undergraduate. Physical examination: T37.5 ℃, poor nutrition, severe anemia, Shen Qing, fatigue, shortness of breath. Cyanosis, face, body visible petechiae petechiae, head palpable on the right side of a 6 × 5cm tumor, the obvious flu. Whole body superficial lymph nodes such as mung bean touched, peanuts large, mobile. Heart and lung no abnormalities, abdominal soft, right rib under the liver 2.5cm, left spleen 3cm, hard. On admission, the number of white blood cells was 60.0 × 10 ~ 9 / L, immature cells 0.25, leaf cells