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1例1.5岁男孩首次静脉滴注头孢曲松钠1.0 g治疗上呼吸道感染时出现寒战、发热,而后转入我院。入院时精神萎靡、面色苍黄。血常规示:Hb 92 g/L,RBC4.21×1012/L,红细胞平均体积(MCV)68.4 fl,红细胞压积(PCV)0.288,网织红细胞(Ret)0.01。入院第2天再次给予头孢曲松钠1.0 g加入5%葡萄糖注射液100 ml静脉滴注。5 h后,患儿全身皮肤黄染,又2 h后出现酱油色尿,T39℃。实验室检测:Hb 45 g/L,RBC 1.83×1012/L,PCV0.12,Ret 0.03,直接Coombs试验(+)。诊断为急性溶血性贫血,立即停药。患者经静脉注射地塞米松、静脉注射丙种球蛋白及输注红细胞后,上述症状缓解,实验室检测示:RBC 3.60×1012/L,Hb 91 g/L,PCV0.289,Ret 0.036。
A 1.5-year-old boy suffered from chills and fever when first intravenous infusion of ceftriaxone sodium 1.0 g for the treatment of upper respiratory tract infection and then transferred to our hospital. Apathetic admission, looking pale. Blood samples were as follows: Hb 92 g / L, RBC 4.21 × 10 12 / L, mean corpuscular volume (MCV) 68.4 fl, hematocrit (PCV) 0.288 and reticulocyte (Ret) 0.01. On the second day after admission, ceftriaxone sodium 1.0 g was given to 100 ml of 5% glucose injection intravenously again. After 5 h, the skin of children with yellow dye, and 2 h after the emergence of soy sauce color urine, T39 ℃. Laboratory tests: Hb 45 g / L, RBC 1.83 x 1012 / L, PCV 0.12, Ret 0.03, direct Coombs test (+). Diagnosis of acute hemolytic anemia, immediate withdrawal. The above symptoms were relieved after intravenous injection of dexamethasone, intravenous gamma globulin and erythrocyte infusion. Laboratory tests showed RBC 3.60 × 1012 / L, Hb 91 g / L, PCV 0.299 and Ret 0.036.