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营养性巨幼细胞性贫血典型病例诊断不难,但表现特殊的病例常可导致漏诊或误诊。我院收治4例表现特殊者,报道如下。病例摘要一、以全血细胞减少、出血为主要表现女患,19岁,因头晕、乏力月余,发热、鼻衄十余天入院。体检:体温38℃。面色苍白,右鼻腔有血迹,颌下淋巴结肿大,有破溃结痂。双肺有少许干罗音。心率120次/分,心尖有Ⅱ级缩鸣,肝脾米触及。化验:红细胞1.4×10~(12)/L,血红蛋白40g/L,
Typical cases of nutritional megaloblastic anemia is not difficult to diagnose, but the performance of special cases can often lead to missed diagnosis or misdiagnosis. 4 cases admitted to our hospital special performance, reported as follows. A summary of cases, to pancytopenia, bleeding as the main performance of female patients, 19 years old, due to dizziness, fatigue, more than a month, fever, epistaxis more than ten days admission. Physical examination: body temperature 38 ℃. Pale, right nasal bloodstains, submandibular lymph nodes, rupture crusting. There are a few dry rales lungs. Heart rate 120 beats / min, apex Ⅱ grade Ming Ming, liver and spleen meters touched. Laboratory: red blood cells 1.4 × 10 ~ (12) / L, hemoglobin 40g / L,