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例1.男,4岁。患儿因突然高热(39.0℃).剧烈头痛,频繁呕吐、反复抽搐、意识不清入院。查体:体温39.6℃,脉搏168次/分.呼吸18次/分,节律不整。神志不清,全身抽搐,面色发绀。瞳孔左>右,对光反射消失。全身皮肤可见少量出血点和淤斑,脑膜刺激征阳性,生理反射消失,巴氏征阳性。血白细胞32×10~9/L,中性84%,杆状5%,诊断为暴发型流脑(脑膜脑炎型)合并小脑幕切迹疝。入院后一条静脉推注20%甘露醇,另一条点滴抗菌药物,同时控制高热、抽搐。4天后病情较稳定,瞳孔恢复正常,但意识仍不清。次日挪动患儿后,突然反复抽
Example 1. Male, 4 years old. Children with sudden fever (39.0 ℃). Severe headache, frequent vomiting, repeated convulsions, unconsciously admitted to hospital. Physical examination: body temperature 39.6 ℃, pulse 168 beats / min, breathing 18 beats / min, irregular rhythm. Confusion, convulsions, cyanosis. Pupil left> right, light reflex disappeared. A small number of systemic skin visible blemishes and ecchymosis, meningeal irritation positive signs, disappearance of physiological reflex, Pakistan sign positive. Blood leukocytes 32 × 10 ~ 9 / L, 84% of neutral, rod 5%, diagnosed as fulminant meningitis (meningoencephalitis type) combined with cerebellar incisional hernia. After admission, a vein injection of 20% mannitol, the other drip antibacterial drugs, while controlling fever, convulsions. 4 days later the condition is stable, the pupil returned to normal, but the awareness is still unclear. After moving the child the next day, suddenly repeated pumping