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我院自1991～1996年共收住15例晚发性维生素K依赖因子缺乏性颅内出血,现就其临床表现,治疗情况及转归作简要报告如下。1 临床资料1.1 一般资料:男6例,女9例;发病年龄28天～2月14例,～4月1例,母乳喂养11例,人工喂养4例。病前有腹泻史4例,上感史2例,母亲有癫痫长服抗痫药1例,肝功能损害2例,PCR～CMV(+)1例,HBsAg(+)1例。发病至就诊时间最短12小时.最长5天。针眼出血不止4例.血便3例,皮肤粘膜出血2例,喷射性呕吐10例.频繁抽搐9例,尖叫3例,思睡12例.昏迷3例,拒食13例.烦躁不安4例,面色苍白15例,前囟膨隆13例,颈强直10例,呼吸不规则4例,瞳孔不等大3例,对光反射迟钝12例、消失3例.肌张力改变7例,腰穿检查均为均匀血性的脑脊液。PT延长,最长达5min。CT检查10例均有颅内出血.其中蛛网膜下腔出血7例,脑实质出血2例.硬膜下血肿并蛛网膜下腔出血2例,低钠血症4例,低氯血症4例。本组有5例误诊为颅内感染,2例误诊为急性胃肠炎。
Our hospital from 1991 to 1996 were admitted to a total of 15 cases of delayed vitamin K-dependent lack of intracranial hemorrhage, and now on its clinical manifestations, treatment and outcome of a brief report is as follows. 1 Clinical data 1.1 General information: 6 males and 9 females; onset age 28 days to 14 months in February, April 1 case, breastfeeding in 11 cases, 4 cases of artificial feeding. There were 4 cases of history of diarrhea, 2 cases of history of sensation, 1 case of antiepileptic drug for long-term epilepsy in mother, 2 cases of liver dysfunction, 1 case of PCR ~ CMV (+) and 1 case of HBsAg (+). The onset of treatment to the shortest 12 hours up to 5 days. Needle eye bleeding in more than 4 cases .Blood stool in 3 cases, skin and mucous membrane bleeding in 2 cases, jet vomiting in 10. Frequent twitching in 9 cases, screaming in 3 cases, sleep in 12 cases .Cooperation in 3 cases, antifeedant in 13. Indign of irritability in 4 cases, Pale in 15 cases, anterior fontanel in 13 cases, ankylosis in 10 cases, irregular breathing in 4 cases, pupil unequal in 3 cases, 12 cases of light reflex in 12 cases, disappeared in 3. Muscle tone changes in 7 cases, lumbar puncture were For bloody cerebrospinal fluid. PT extended, up to 5min. CT examination of 10 patients had intracranial hemorrhage, including 7 cases of subarachnoid hemorrhage, cerebral parenchymal hemorrhage in 2 cases. Subdural hematoma and subarachnoid hemorrhage in 2 cases, 4 cases of hyponatremia, hypochlorosis in 4 cases . This group of 5 patients misdiagnosed as intracranial infection, 2 patients misdiagnosed as acute gastroenteritis.