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词汇介绍
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解析
hemolytic 英 [hi:'mɒlɪtɪk] 美 [hi:'mɒlɪtɪk]
释义 adj. [生理][免疫] 溶血的
例句 Objective:To compare the prediction effect on hemolytic disease of the newborn between monocyte monolayer assay and antibody titre.
目的：单核细胞单层试验和抗体效价测定试验预判新生儿溶血病的预测效果。
jaundice 英 [ˈdʒɔ:ndɪs] 美 [ˈdʒɔndɪs, ˈdʒɑn-]
释义 n. 黄疸；偏见；乖僻
vt. 使怀偏见；使患黄疸
例句 Leptospirosis causes severe jaundice, kidney failure and bleeding in the lungs.
钩端螺旋体导致严重的黄疸、肾衰竭和肺出血。
概述
概述
血清总胆红素在34 umol/L以上，临床上即表现有黄疸。巩膜、皮肤无黄染，而血清总胆红素超过正常值，则称为隐性黄疸。溶血性黄疸（hemolytic jaundice）指由于各种原因造成的红细胞被大量破坏，在网状内皮细胞中生成的胆红素过多，超过肝摄取、结合与排泄的能力，造成血中间接胆红素浓度异常增高引起的黄疸。各种引起大量溶血的原因都可造成溶血性黄疸。
病因
凡能引起溶血的疾病都可引发溶血性黄疸。常见病因如下：
（1）先天性溶血性贫血 如海洋性贫血、遗传性球形红细胞增多症等；
（2）后天性获得性溶血性贫血 如自身免疫性溶血性贫血、新生儿溶血病、不同血型输血后的溶血及蚕豆病、伯氨喹啉、蛇毒、毒蕈、阵发性睡眠性血红蛋白尿等。
诊断
（1）血清以非结合胆红素增高为主，一般占总胆红素的80%以上；
（2）有贫血症状；
（3）血液学检查有不同程度正色性贫血，网织红细胞增高（常大于5%）；
（4）尿中尿胆原阳性，尿胆红素阴性；
（5）急性溶血时可有血红蛋白尿，尿呈酱油色。
临床表现
皮肤、巩膜及黏膜发黄，急性溶血可有发热、寒战、头痛、呕吐、腰痛，并有不同程度贫血和血红蛋白尿。
治疗
治疗原则：主要为针对病因治疗及对症治疗。
首先是针对溶血性疾病本身的治疗：清除病因、去除诱因、对症治疗，其次为对症退黄治疗，临床上常用的有茵栀黄、思美泰等，但必须强调，如溶血未解除，退黄是困难的，而且效果是暂时的。其他治疗：对新生儿可用光照和输血治疗。
31-Year-Old Woman With Jaundice and Abdominal Pain
复制标题
31岁妇女，黄疸和腹痛
发表时间：2019-09-01
影响指数：7.1
作者： Daniel D. Penrice
期刊：Mayo Clin. Proc.
A31-year-old woman presented with a 3-month history of persistent jaundice. She worked as a school teacher and a student had made a comment that her eyes appeared yellow approximately 3 months before presentation. During this time, she had also noticed darkening of her skin diffusely. She had believed that these changes were secondary to indoor tanning, which she did once weekly. One week prior she developed sharp right upper quadrant abdominal pain that was worse with lying on her right side. She also began to appreciate mild lower extremity edema and darkening of her urine. Her medical history was notable for alcohol use disorder, obesity status post Roux-en-Y gastric bypass with current body mass index of 31 kg/m2 , seizure disorder, and major depressive disorder. She first began consuming alcohol at age 16 and had prolonged periods of alcohol abuse with intermittent episodes of sobriety. One year prior, she had undergone an intensive inpatient alcohol rehabilitation program. However, she admitted consuming alcohol following completion of rehabilitation, approximately “once per week.” Her last drink was three days before presentation. She was taking no medications at the time of her presentation.
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