患者,女,25岁。主因产后一周牙龈出血伴发热3天急诊入院。患者7天前顺产一足月女婴,3天前无诱因牙龈出血不止,伴发热,体温39℃,次日口腔多处疼痛。出现血泡,且全身皮肤散在出血点,以下肢为甚,伴头晕、乏力、心悸、纳差。产后出血、恶露正常,无药物应用史。既往体健。查体:T39.2℃,重度贫血貌,全身皮肤可见散在出血点以下肢为甚,口腔多处溃疡及血泡,牙龈可见血迹,胸骨无叩压痛,双肺叩听正常,心尖部可闻及Ⅱ级收缩期杂音,肝脾肋下未及,下腹轻压痛,子宫复旧可,双下肢Ⅱ°可凹性水 Patient, female, 25 years old. The main one week after delivery due to bleeding gums with fever 3 days emergency admission. 7 days ago, patients with full-term full-term baby girl, 3 days ago, there is no incentive bleeding bleeding gums, with fever, body temperature 39 ℃, multiple oral pain the next day. Blood bubble appears, and the whole body scattered in the bleeding point to the lower limbs even worse, with dizziness, fatigue, palpitations, anorexia. Postpartum hemorrhage, lochia normal, no history of drug use. Past physical health. Physical examination: T39.2 ℃, severe anemia, the whole body visible scattered scattered bleeding in the lower limbs is even more, multiple oral ulcers and blood vessels, visible blood stains on the gums, sorebone no tenderness, the lungs tap normal, the apex can be heard And Ⅱ grade systolic murmur, liver and spleen ribs, lower abdomen mild tenderness, uterine involution may, both lower limb Ⅱ ° concave water