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维生素 K 缺乏所致婴儿颅内出血,常被误诊为化脓性脑膜炎或败血症并发弥漫性血管内凝血等而延误治疗,导致永久性的神经系统后遗症,甚至死亡。中国医科大学附属第二医院和上海市儿童医院最近综合报道了本病33例,其中生后1～2个月者31例,母乳喂养27例,起病1/2～2天入院28例。患儿多于夜间突然出现中枢神经系统症状。表现为前囟饱满、呻吟(29例),两眼凝视、瞳孔不等大、呼吸不整(26例),呕吐、烦躁、惊厥或意识障碍(17例),肢体强直或屈曲(11例),发热(18例);贫血明显且进行性加重(28例),皮下出血及便血(25例),黄疸(15例)。此外,部分患儿还有注射部位出血不止、面瘫或眼睑下垂,脑膜刺激征及巴氏征阳性等。血红蛋白2.4～9.7克,红细胞130万～320万/立方毫米。
Infant intracranial hemorrhage caused by vitamin K deficiency, often misdiagnosed as purulent meningitis or sepsis complicated by diffuse intravascular coagulation and delayed treatment, leading to permanent neurological sequelae, and even death. The Second Affiliated Hospital of China Medical University and Shanghai Children’s Hospital recently reported 33 cases of this disease, including 1 to 2 months after birth in 31 cases, breastfeeding in 27 cases, onset 1/2 to 2 days admitted to 28 cases. There were more sudden central nervous system symptoms in children than in nighttime. There were 29 cases with full anterior fontanelle, two eyes staring, large pupils, breathing irregularities (26 cases), vomiting, irritability, convulsions or disturbance of consciousness (17 cases), limb rigidity or flexion (11 cases) Fever (18 cases), anemia was obvious and progressive (28 cases), subcutaneous hemorrhage and hematochezia (25 cases), jaundice (15 cases). In addition, some children also have bleeding at the injection site, facial paralysis or ptosis, meningeal irritation and positive Pap test. Hemoglobin 2.4 ~ 9.7 grams, 1.3 million erythrocytes ~ 3.2 million / cubic millimeter.