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患儿,男,出生体重3500克,孕39~(+3)周,平产,Apgar评分10分,出生后第3天患儿因鹅口疮,医务人员指导用2%碳酸氢钠清洗口腔和以浓鱼肝油滴剂1瓶(每瓶15毫升装,每克含维生素A10000国际单位,维生素D5000国际单位),加克霉唑0.25×4片混合后涂布口腔粘膜,其家属2天内将此药用完,用药后第3天,患儿出现神萎,喷射状呕吐,伴双上肢抽搐来院就诊。 体查:精神软弱,前囱明显隆起,紧张,颅缝增宽,头围38.5cm,两眼球内凝视,眼球震颤,无落日征,颈无抵抗,心肺正常,腹软,肝右肋下1.5cm,质软,全身皮肤正常,无出血点,神经系统正常,血常规:血红蛋白162克/L,红细胞6.36×10~(12)/L,白细胞7.32×10~(9)/L,中性0.53,淋巴0.47,脑脊液检查:腰穿时仅发现脑脊液压力增高(17kPa),无细胞及生化改变。入院后考虑:1.
Pediatric, male, Birth weight 3,500 g, Pregnancy 39 to (+3) weeks, Stillbirth, Apgar score 10, Third day after birth due to thrush, Medical staff instructions 2% Sodium bicarbonate to clean the mouth and Take a bottle of concentrated cod liver oil drops (15 ml each bottle containing vitamin A10000 international units, vitamin D5000 international units) plus clotrimazole 0.25 × 4 tablets coated oral mucosa, the family members within 2 days of the drug Run out, the first 3 days after treatment, children appear wilted, jet-like vomiting, with double upper extremities convulsions to hospital. Physical examination: the spirit of weakness, obviously bulging before the chimney, tension, cranial suture widening, head circumference 38.5cm, both eyes staring, nystagmus, no sun signs, neck non-resistance, normal heart and lung, cm, soft, normal skin, no bleeding, normal nervous system, blood routine: 162 g / L hemoglobin, 6.36 × 10 12 / L erythrocytes, 7.32 × 10 9 / L, 0.53, lymphatic 0.47, cerebrospinal fluid examination: only elevated cerebrospinal fluid pressure (17 kPa) was found at lumbar puncture, with no cellular or biochemical changes. After admission consider: 1.