论文部分内容阅读
讨论患儿主要表现为新生儿在二个月时出现黄疸,肝脾肿大,肝功轻微异常,甲胎蛋白阳性,乙型肝炎抗原阴性,贫血。新生儿黄疸在临床上并不少见,有时诊断颇为困难,根据本例情况讨论如下: (一)诊断方面: 1.溶血性黄疸:患儿血红蛋白低,有贫血及黄疸,肝脾肿大。临床上新生儿溶血性黄疸并不少见,有人曾将贫血、黄疸及脾肿大称为溶血性贫血的三大表现,故可能因此而在×院诊断为溶血性贫血。溶血性黄疸大致可分为红细胞内缺损和红细胞外原因两大类,前者如球形细胞及椭圆形细胞增多症,镰形细胞贫血及地中海贫血及阵发性夜间血红蛋白尿等,国内先后均有过报告。后者如获得性自身免疫性溶血性贫血及感染、化学物理等因素引起的溶血性黄疸。患儿虽有黄疸,贫血、感染疖肿及用药史,但黄疸以直接胆红质增高为主,大便粪胆
Discussion The main manifestations in children with neonatal jaundice at two months, hepatosplenomegaly, mild abnormal liver function, a-fetoprotein positive, hepatitis B antigen-negative, anemia. Neonatal jaundice is not uncommon in clinical, and sometimes quite difficult to diagnose, according to the situation in this case are discussed as follows: (A) the diagnosis: 1. Hemolytic jaundice: children with low hemoglobin, anemia and jaundice, hepatosplenomegaly. Clinical neonatal hemolytic jaundice is not uncommon, some people have anemia, jaundice and splenomegaly known as the three major manifestations of hemolytic anemia, it may therefore be diagnosed in × × hemolytic anemia. Hemolytic jaundice can be divided into two major categories of intra-erythrocytic defects and extra-corpus causes, the former such as spherical cells and oval polycythemia, sickle-cell anemia and thalassemia and paroxysmal nocturnal hemoglobinuria, etc., have had report. The latter, such as acquired autoimmune hemolytic anemia and infection, chemical and physical factors such as hemolytic jaundice. Although children with jaundice, anemia, infection and carbuncle swollen medication history, but jaundice mainly to direct bilirubin, stool fecal