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真性红细胞增多症的最后确诊,要靠实验室的检查。我们考虑到用组织病理切片检查,可算一个项目,因此我们对本患者,进行了皮肤病理检查,更显示了本病充血的特征,肯定诊断。 患者,女,农民。以全身皮肤发红,面部深红,口唇与四肢末端红紫而来院。体检:T36.8℃,P87次/分,R22次/分,BP偏高。重病容,发育正常,神智清楚,能合作。全身皮肤粘膜无不发红,舌鲜红、唇紫,眼结膜极度充血,四肢远端红紫。心率快,肺呼吸音粗糙,ECG左室向左扩大,X线:肺纹理增多。肝未触及,脾肋下5cm,B超:肝未见异常,脾大4.9cm,内部回声尚少。眼底A硬化,视神经乳头水肿。ECG脑血管静脉洄流阻滞。
The final diagnosis of polycythemia vera depends on laboratory tests. We consider the use of histopathological examination, can be considered a project, so we in this patient, a skin examination, but also shows the characteristics of the disease congestion, positive diagnosis. Patient, female, farmer. Redness to the whole body skin, facial dark red, lips and limbs purple red from the hospital. Physical examination: T36.8 ℃, P87 beats / min, R22 beats / min, BP high. Seriously ill, normal development, clear mind, can cooperate. All skin and mucous membranes are red, red tongue, lip purple, conjunctival hyperemia, distal red purple limbs. Heart rate, rough lung breath sounds, ECG left ventricular enlargement to the left, X-ray: increased lung markings. Liver did not touch, spleen rib 5cm, B-super: no abnormal liver, spleen 4.9cm, less internal echo. Fundus A sclerosis, optic nerve head edema. ECG cerebrovascular vein vortex block.