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例1,3岁男孩,因发烧、呕吐3天,水泻1天入院,2个兄弟和母亲均有血性腹泻。查体呈中度脱水貌,入院后第五天血红蛋白和血小板下降到90g/L和9.1×10~9/L、网织红细胞2.5％,血涂片示许多断裂的红细胞,血钠119mmol/L,血钾3.7mmol/L,尿素氮16.42mmol/L,肌酐106μmol/L。大便培养见志贺氏—弗氏痢疾杆菌,确诊溶血尿毒综合症。10天后出现肾衰、高血压脑病,开始腹膜透析,12天在右肋下发现5×6cm大的胆囊。第二夭发现颊粘膜溃疡,肩、阴茎、肛周皮肤表层坏死,一周后损害范围缩小,十天后消失,因全身状况恶化在二周后死亡。
Example 1, 3-year-old boy, 3 days due to fever, vomiting, watery diarrhea admission one day, 2 brothers and mothers have bloody diarrhea. Examination showed a moderate dehydration appearance, the fifth day after admission hemoglobin and platelets dropped to 90g / L and 9.1 × 10 ~ 9 / L, reticulocyte 2.5%, blood smear showed a lot of broken red blood cells, serum sodium 119mmol / L , Potassium potassium 3.7mmol / L, urea nitrogen 16.42mmol / L, creatinine 106μmol / L. Stool culture see Shi’es - Shigella flexneri bacteria, diagnosis of hemolytic uremic syndrome. Renal failure, hypertensive encephalopathy ten days later, peritoneal dialysis started, and a large 5 × 6 cm gallbladder was found in the right flank 12 days later. The second yao found buccal mucosal ulcers, shoulder, penis, perianal skin surface necrosis, a week after the lessening of the scope of the shrink, disappeared ten days later, due to the deterioration of the general condition of death in two weeks.