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急性白血病以发热、贫血、肝脾及淋巴结肿大为主要特点,合并截瘫者甚少。作者曾收治一例急性粒细胞性白血病并发截瘫者,而被误诊为急性脊髓炎。患者吕××,男,33岁,发热、腰部持续性隐痛六天后,双下肢麻木、乏力,继之呈进行性瘫痪,小便潴留,双目视物不清,于1981年4月28日以急性脊髓炎入院。既往体健,家族中无血液病及其他疾病史。查体:T38.3℃,P100次/分,R20次/分,BP100/60mmHg。发育正常,营养中等,神志清,皮肤粘膜无异常.腋下及腹股沟有数个淋巴结肿大似花生米.双眼球突出,瞳孔等大等园,对光反射良好.颈软、胸骨有明显压痛,心肺正常.腹部稍胀、无压痛。肝大在右锁骨中线肋下约4厘米,质软,轻度压痛,脾在左肋下约2.5厘米,中等硬度,有叩击痛.肠鸣音存在,指趾呈杵状.两上
Acute leukemia with fever, anemia, liver and spleen and enlarged lymph nodes as the main features of patients with very few paraplegia. The author has admitted to a case of acute myeloid leukemia complicated by paraplegia, and was misdiagnosed as acute myelitis. Patients Lu × ×, male, 33 years old, fever, persistent pain in the waist after six days, numbness of both lower limbs, fatigue, followed by progressive paralysis, retention of urine, binocular vision is unclear, in April 28, 1981 to Acute myelitis hospitalization. Past physical health, family history of no blood diseases and other diseases. Physical examination: T38.3 ℃, P100 beats / min, R20 beats / min, BP100 / 60mmHg. Normal development, moderate nutrition, clear consciousness, no abnormal skin and mucous membranes. Armpits and groin has several lymph nodes swollen like peanuts .Double eyeball prominent pupil and other large garden, the light reflection is good .Soft neck, sternal tenderness, Cardiopulmonary normal abdominal slightly swollen, no tenderness. Large liver in the right clavicle under the ribs about 4 cm, soft, mild tenderness, spleen in the left rib about 2.5 cm, moderate hardness, percussion pain. Bowel sounds exist, toe was clubbing.