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女,34岁。近两年反复低热、盗汗、乏力、食欲不振,未行治疗。因查体发现脾大,贫血,于1987年8月14日收入院。体检:中度贫血貌,腹平软、肝剑下3 cm,右肋缘下1 cm,质稍韧,表面光滑,肝上界于右锁骨上第五肋间。脾脏左肋缘下 6cm,质韧。血红蛋白78g/L,血小板80×10~9/L,白细胞3.4×10~9/L,中性52％,淋巴40％。肝功正常。胸透(一)。临床诊断:脾肿大并脾功能亢进,硬膜外麻醉下行脾切除术。术后病理诊断:脾结核。术后追加抗痨治疗。术后,血小板、血红蛋白及白细胞均逐渐增多。术后30天查:血小板100×10~9/L,血红蛋白110g
Female, 34 years old. Repeated fever in recent years, night sweats, fatigue, loss of appetite, no treatment. Because of physical examination found splenomegaly, anemia, on August 14, 1987 income hospital. Physical examination: moderate anemia appearance, abdominal soft, under the liver sword 3 cm, 1 cm right rib margin, quality slightly tough, smooth surface, the upper limit of the liver in the right intercostal fifth intercostal space. Spleen left costal 6cm, quality tough. Hemoglobin 78g / L, platelets 80 × 10 ~ 9 / L, white blood cells 3.4 × 10 ~ 9 / L, neutral 52%, lymphatic 40%. Normal liver function. Chest through (a). Clinical diagnosis: splenomegaly and hypersplenism, epidural anesthesia for splenectomy. Postoperative pathological diagnosis: splenic tuberculosis. Postoperative anti-tuberculosis treatment. After surgery, platelets, hemoglobin and white blood cells are gradually increased. 30 days after surgery: platelets 100 × 10 ~ 9 / L, hemoglobin 110g