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目的提高对以骨关节痛为早期表现的小儿白血病的认识,避免误诊误治。方法对以骨关节痛为早期表现的小儿白血病15例进行回顾分析。结果本组15例均经骨髓细胞学检查确诊为小儿白血病,其中ALL12例;发病以学龄儿童为主,男女之比为2∶1;多数患儿伴不规则发热及肝脾肿大,所有病例外周血象均有一项或多项异常;骨关节X线检查多无异常;多数病例较长时间被误诊误治。结论以骨关节痛为早期表现的小儿白血病,其早期症状可单一不典型,若对其认识不足、警惕性不高,易引起误诊误治。临床上凡遇骨关节痛诊断为风湿或类风湿性关节炎而经抗风湿效果不佳者,应高度警惕,耐心细致的体格检查,反复血涂片和及时的骨髓检查,对于早期确诊小儿白血病有极其重要的意义。
Objective To raise awareness of childhood leukemia, an early manifestation of osteoarthritis, to avoid misdiagnosis and mistreatment. Methods A retrospective analysis of 15 cases of childhood leukemia with early osteoarthritis was performed. Results The group of 15 cases were diagnosed as pediatric leukemia by bone marrow cytology, of which ALL12 cases; incidence of school-based children, male to female ratio of 2: 1; most children with irregular fever and hepatosplenomegaly, all cases Peripheral blood has one or more abnormalities; bone and joint X-ray examination without abnormalities; the majority of cases longer misdiagnosis and mistreatment. Conclusions Osteoid joint pain is an early manifestation of pediatric leukemia. Its early symptoms may be single atypical. If it is not well-known, vigilance is not high, which may lead to misdiagnosis and mistreatment. Any clinical diagnosis of bone and joint pain rheumatoid or rheumatoid arthritis and rheumatic poor results should be highly vigilant, patient and meticulous physical examination, repeated blood smear and timely bone marrow examination, early diagnosis of childhood leukemia Have extremely important meaning.