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病例摘要:女,34岁,工人。“O”型血。1974年3月始腰部隐痛,伴浮肿。1976年8月起腰疼明显加重,伴发热,行动极为困难,棘突畸形。曾按肾炎和风湿治疗无效。1977年10月拍X光片确诊为腰椎结核收入院。查体:神志清,发育正常,营养中等,行动困难。体温37.2℃,脉搏96次/分,血压160/110mmHg;血沉8～20mm/h。心、肺、肝、脾无异常。腰椎3、4棘突畸形。X光片显示:腰椎3、4间隙狭窄,边缘不整,椎体破坏,双侧腰大肌影增密。诊为腰椎结核,并发双腰大肌脓肿,后突畸形。手术治疗。术前室温(18℃)配血试验,主副交叉均为强阳性,4次试验结果相同。37℃下5分钟仍为阳性,15分钟为阴性。离开37℃即刻又呈阳性反应。经上级医院鉴定,血型为“O”型,患者血清中含自身冷凝集素,效价为1024倍。
Case Summary: Female, 34 years old, worker. “O” type blood. March 1974 beginning of the waist pain, with edema. August 1976 back pain significantly increased, with fever, extremely difficult action, spinous process deformity. Nephritis and rheumatism have been treated ineffective. October 1977 X-ray film confirmed lumbar tuberculosis income hospital. Examination: Consciousness, normal development, moderate nutrition, difficult operation. Body temperature 37.2 ℃, pulse 96 beats / min, blood pressure 160 / 110mmHg; ESR 8 ~ 20mm / h. Heart, lung, liver, spleen without exception. Lumbar spine 3, 4 deformity. X-ray film showed: lumbar spine 3, 4 narrow gap, incomplete edge, vertebral body destruction, bilateral shadow enlargement. Diagnosis of lumbar tuberculosis, complicated by double-pumped muscle abscess, sudden deformity. Surgical treatment. Preoperative room temperature (18 ℃) with the blood test, the main cross were strong positive, 4 times the same test results. 5 minutes at 37 ° C is still positive, negative for 15 minutes. Leave 37 ℃ immediately positive again. The higher level hospital identification, blood type “O” type, the patient’s serum containing self-cold agglutinin, potency of 1024 times.