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患儿男性,12岁,1984年12月27日住院。患儿两天前发热,体温高达40℃,伴阵发性脐周疼痛及恶心、呕吐,并出现肉限血尿,无尿频、尿急及浮肿。入院前一小时,患儿突然双眼凝视,口唇发绀,神志不清急诊入院。既往体健。查体:体温37℃,脉搏126次,呼吸56次,血压测不到。意识丧失,两侧瞳孔中度散大,对光反应消失。口唇发绀,颈稍有抵抗,两肺正常,心音低钝。病理反射未引出。实验室检查:血白细胞58,000,中性90%,淋巴10%,血小板5万。尿:蛋白(++),红细胞(++)。GPT212单位,总胆红素定量5mg%,脑脊液正常。住院经过:入院后经抗休克等对症治疗,4小时后血压升至90/60mmHg,皮肤巩膜出现黄染,左腋下可见针尖大小出血点,部分融合。24小时尿量约
Male patient, 12 years old, hospitalized December 27, 1984. Children with fever two days ago, body temperature up to 40 ° C, with paroxysmal nocturnal pain and nausea and vomiting, and meat limit hematuria, no urinary frequency, urgency and edema. An hour before admission, children suddenly staring at his eyes, lips cyanosis, confusion emergency admission. Past physical health. Physical examination: body temperature 37 ℃, pulse 126 times, breathing 56 times, blood pressure can not be measured. Loss of consciousness, both sides of the pupil moderately dispersed, the response to light disappeared. Cyanosis lips, neck slight resistance, normal lungs, low heart sound blunt. Pathological reflex did not lead. Laboratory tests: 58,000 white blood cells, 90% neutral, 10% lymphomas, 50000 platelets. Urine: protein (++), erythrocytes (++). GPT212 units, total bilirubin 5mg% quantitative, normal cerebrospinal fluid. After hospitalization: After admission by anti-shock and other symptomatic treatment, 4 hours after the blood pressure rose to 90 / 60mmHg, the skin sclera appears yellow dye, the left underarm can see the tip size of bleeding, the partial fusion. 24-hour urine output about