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患儿,男,10岁,因发热1d、手足搐搦半天入院。起病后非喷射状呕吐2次,为少量胃内容物,排黄稀便1次,无多饮、多尿、遗尿。查体:神清,精神可,血压13.3/8 kPa(100/60mmHg),体重28kg,身高136cm,指间距126cm,上部量/下部量为1:1,生长发育为正常低水平,双手腕部屈曲,手指伸直,拇指内收,强直痉挛。咽充血,双侧扁桃体I度红肿,无分泌物,颈软,心肺腹无异常,四肢肌张力正常,神经系统未见异常。实验室检查:血清钠、氯、钙、离子钙、镁,肝、肾功均正常,连测3次血气示代谢性碱中毒:pH7.437-7.483,BE4.9-7.2,HCO3- 28.8-31 mmol/L。连测3次血清钾均
Children, male, 10 years old, due to fever 1d, tetany for a long time admitted. After the onset of non-jet-like vomiting 2 times for a small amount of stomach contents, row yellow diluted 1 time, no more drink, more urine, enuresis. Examination: Shen Qing, spirit can, blood pressure 13.3 / 8 kPa (100 / 60mmHg), weight 28kg, height 136cm, finger spacing 126cm, the upper / lower amount of 1: 1, the growth and development of normal low level, both wrists Flexion, finger straight, thumb adduction, tonic spasms. Pharyngeal congestion, bilateral tonsil I degree swelling, no secretions, neck soft, no abnormal heart and lung, abdominal muscle tone normal, no abnormalities in the nervous system. Laboratory tests: Serum sodium, chlorine, calcium, ionized calcium, magnesium, liver, kidney function were normal, and even measured 3 times blood gas showed metabolic alkalosis: pH7.437-7.483, BE4.9-7.2, HCO3- 28.8- 31 mmol / L. Even measured serum potassium 3 times