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患儿,女,5岁,59年12年8日初诊。主诉,三日来嗜睡,(?)心,呕吐,不能进食。三月前经其母发现其左眼球向外偏斜,瞳孔內有黄色反光,形似猫眼。三日前玩耍时不慎将左眼碰伤,未见流血,但感到左眼球疼痛,并有恶心、呕吐,嗜唾。先到本院內科急诊治疗,经眼科会诊入院。既往三年来常患消化不良。1956年3月间前额部曾出现多数红色米粒大之疮疹。1958年6月被铁钉帽碰破前额中部皮肤。同年6月曾患麻疹,12月曾有鼻衄,翌年又有数次。1959年1月曾患四肢抽搐,口吐白沫,口唇发绀,患儿为第二胎足月顺产。父母健康,否认性病史。一兄一妹均健康。追问家族中未发现有眼部异常病变之患者。查体:体温脉搏正常,发育良好,营养中等,嗜睡。左颌下可触到0.5×0.5厘米大小的淋巴结,无压痛。(?)龋齿,咽部未见异常。鼻粘膜充血,未见血管瘤,心肺正常,肝脾不大。头部 x 光照片正常。胸部透视正常。化验检查:血缸蛋白12.4克%,红细胞436万/立方毫米,白细胞9300/立方毫米;分类:中性60%,淋巴38%,单核1%,嗜酸球1%。出血时间3分,凝血时间(Sabraze氏法)2.5分。血小板24万/立方毫米,毛细血管脆性正常,尿粪常规检查未发现异常。
Children, women, 5 years old, 59 years 12 years 8 early diagnosis. Chief complaint, three days to sleepiness, (?) Heart, vomiting, can not eat. Three months ago by his mother found that his left eye outward deflection, the pupil with yellow reflective, shaped like a cat’s eye. Three days ago play accidentally bruised his left eye, did not see the bleeding, but felt pain in the left eye and nausea, vomiting, addicted to saliva. First hospital emergency treatment, the hospital admitted by the eye. In the past three years often suffer from indigestion. In March 1956, most of the redheads were found in the forehead department. June 1958 was pinned to break the middle of the forehead in the middle of the skin. In the same year, she had measles in June, had epistaxis in December and several times in the following year. January 1959 had limb twitching, foaming at the mouth, lips cyanosis, full-term childbirth for the second child. Parents health, denied sexual history. One brother and one sister are healthy. Asked the family did not find any abnormal eye lesions. Physical examination: normal temperature pulse, well-developed, moderate nutrition, lethargy. Left mandible can reach the size of 0.5 × 0.5 cm lymph nodes, no tenderness. (?) Dental caries, throat no abnormalities. Nasal mucosal hyperemia, no hemangioma, normal heart and lungs, liver and spleen is not. Head x-ray photos normal. Chest perspective normal. Laboratory tests: 12.4 grams of blood protein cylinder, 4360000 / cubic mm of red blood cells, white blood cells 9300 / cubic mm; classification: 60% of neutral, lymphatic 38%, mononuclear 1%, 1% of eosinophils. Bleeding time 3 points, clotting time (Sabraze’s method) 2.5 points. Platelets 240,000 / cubic mm, capillary fragility normal, urine fecal routine examination found no abnormalities.