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患者,男,47岁。因左侧鼻腔反复出血1个月于2009年11月入院。患者有反复鼻出血病史10余年,每次出血10~20ml,常因感冒或打喷嚏而诱发。近1个月来左侧鼻腔出血频繁,每次出血20~100ml。于外院反复行鼻腔填塞,但效果不佳并多次输血。患者有高血压病史及IgA肾病病史,曾在肾活检时出现大出血。家族中8人有反复鼻出血病史。查体:贫血貌,血压170/110mm Hg(1mm Hg=0.133kPa)。左侧鼻腔已填塞,口咽
Patient, male, 47 years old. Repeated bleeding on the left nasal cavity for 1 month in November 2009 admitted. Patients with repeated history of nasal bleeding more than 10 years, each bleeding 10 ~ 20ml, often caused by a cold or sneezing. Nearly a month to the left nasal bleeding frequently, each bleeding 20 ~ 100ml. In the outer courtyard repeated nasal packing, but ineffective and multiple transfusions. The patient had a history of hypertension and a history of IgA nephropathy, and hemorrhage occurred on a renal biopsy. Eight people in the family have a history of repeated nosebleeds. Physical examination: anemia appearance, blood pressure 170/110 mm Hg (1 mm Hg = 0.133 kPa). The left nasal cavity has been filled, oropharyngeal