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病例女,1岁8个月。开水烫伤臀,双下肢30％,Ⅲ度15％,伤后4小时入院。查:体温37.8℃,脉搏160次/分,呼吸48次/分。烦躁不安,四肢冰冷,无尿。全身皮肤粘膜未见黄染及出血点,肝脾淋巴结无肿大。创面泡皮完全撕脱。实验室检查:WBC 66.0×10~9/L,N0.90,L0.10。入院后即给予2 ml·kg(~-1)·TBSA％、晶胶比例1:1补液抗休克,创面外涂磺胺嘧啶银糊剂,暴露烤灯。由于患儿白细胞异常增高,故在补液有尿,安静后行胸骨穿刺,骨髓像示:粒细胞系统增生活跃,幼粒细胞偶见,少于10％,红细胞系和巨核细胞系正常,提示类粒细胞白血病反应。伤后第一个24小时尿
Case female, 1 year and 8 months. Boiled scalded hip, lower limbs 30%, Ⅲ degree 15%, 4 hours after injury admission. Check: body temperature 37.8 ℃, pulse 160 beats / min, breathing 48 beats / min. Irritability, cold limbs, no urine. No yellow skin and mucosal mucosa bleeding and bleeding points, no swelling of the liver and spleen lymph nodes. Wound completely peeling skin. Laboratory tests: WBC 66.0 × 10 ~ 9 / L, N0.90, L0.10. After admission to give 2 ml · kg (~ -1) · TBSA%, crystal gel ratio of 1: 1 rehydration anti-shock wounds coated with sulfadiazine silver paste, exposed lamp. Because of abnormal high levels of leukocytes in children, so in the rehydration of urine, quiet sternum puncture, bone marrow showed: granulocyte system hyperplasia, promyelocytic occasional, less than 10%, erythrocyte and megakaryocyte normal, suggesting that type Myeloid leukemia reaction. The first 24-hour urine after injury