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患者女性,7岁.于1996年7月出现(?)牙痛,继而同侧面颊部肿胀.先后两次行X线摄片,均诊断为右下颌骨骨髓炎;先后两次行开髓刮治术,疗效均欠佳.病程中曾有左大腿剧痛,逐渐缓解,后发现左大腿内侧有一质硬包块,于1996年11月22日来我院口腔科诊治.入院检查:生命体征正常,一般情况良好.右面部明显肿胀,右下颌部可及约1.5cm×1.5cm淋巴结2枚,无压痛、质韧、活动;右颌下有一长约3mm切开引流的创口,并有炎性肉芽组织隆起.(?)开髓、(?)浅龋.肝脏于肋下3cm、剑突下10cm可触及,有压痛、质地中等、表面光滑.左大腿内侧可及一大约4cm×6cm的包块、质硬、固定、无压痛.白细胞9.5×10~9/L、中性0.685淋巴0.315,红细胞4.34×10~(12)/L,血小板408×10~9/L,血沉60mm/h,AKP181Iu/L,肝功能正常.多次x线摄片均提示右下颌骨及左股骨骨髓炎.住院期间发现耳后及左锁骨上窝有肿大的淋巴结多枚,耳后1枚最大的约3cm×3cm,质韧、表面光滑、固定、有压痛,右眼内眦部有一约1cm×0.5cm的包块,质硬、无压痛、不活动.先后两次按“右
Patient female, 7 years old. In July 1996, (?) toothache, followed by swelling of the same side of the cheek. X-ray two consecutive radiographs were diagnosed as right mandibular osteomyelitis; have two lines of open myelopathy Surgery, the effect is poor. During the course of the disease, there was pain in the left thigh, gradually relieved, and found a hard mass in the left thigh. He came to our hospital for dental treatment on November 22, 1996. Admission examination: normal vital signs , The general condition is good. The right face is obviously swollen. The right lower jaw is about 1.5cm x 1.5cm with 2 lymph nodes. There is no tenderness, quality, toughness and activity. There is a wound about 3mm long incision and drainage in the right submandibular, and it is inflammatory. The granulation tissue uplift. (?) Open pulp, (?) Shallow. Liver in the ribs 3cm, 10cm below the xiphoid can be palpable, tenderness, medium texture, smooth surface. The inner thigh can reach about a 4cm × 6cm package Block, hard, fixed, no tenderness. White blood cells 9.5×10 9/L, neutral 0.685 lymph 0.315, red blood cells 4.34×10 12/L, platelets 408×10 9/L, ESR 60 mm/h, AKP181Iu/L, normal liver function. Multiple x-rays suggest osteomyelitis of the right mandible and the left femur. During hospitalization, a large number of lymph nodes were found behind the ear and in the left supraclavicular fossa, with one in the ear. About 3cm × 3cm, quality and tough, smooth surface, is fixed, tenderness, right eye canthus has a mass of about 1cm × 0.5cm, hard, no tenderness, inactive. Press twice "right