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患儿女,2岁,因咳嗽4天,无尿2天,昏迷1天,于1999年2月3日入院。患儿入院前4天因受凉出现咳嗽、流清涕,体温不高,家长自行喂服复方新诺明治疗,每日3次,每次1片,先后服用4次,患儿咳嗽无减轻,尿量逐渐减少,入院前2天开始无尿,入院前1天患儿昏迷不醒,在当地医院给予抗感染、对症治疗,病情无好转,逐转入我院。 入院体检:T 36.8℃,P 128次/分,R 40次/分,BP 11/7 kPa昏迷状态,压眶反应阴性。双瞳孔等大等园,对光反射迟钝。颈部轻度抵抗。双肺可闻及喘鸣音及小水泡音。腹软,肝右肋下3cm、剑下3.5cm,质软。移动性浊音阴性。膝腱反射减弱,巴氏征阴性。实验室检查:血常规;白细胞15×10~9/L,中性0.72、淋巴0.28;红细胞4.2×10~(12)/L,血红蛋白120g/L。肌酐486.2
Children, 2 years old, cough for 4 days, anuria for 2 days, coma for 1 day, was admitted on February 3, 1999. Children admitted to hospital four days before due to cold appeared cough, runny nose, body temperature is not high, the parents themselves fed compound cotrimoxazole treatment, 3 times a day, each 1, has taken 4 times, no reduction in children with cough, Urine gradually reduced, 2 days before admission began anuria, 1 day before admission, children unconscious, anti-infectives in the local hospital, symptomatic treatment, the condition did not improve, turn into our hospital. Admission examination: T 36.8 ℃, P 128 beats / min, R 40 beats / min, BP 11/7 kPa coma, orbital reaction negative. Double pupil and other large garden, slow reflection of light. Neck slightly resistant. Two lungs can be heard wheezing and small blisters sound. Abdominal soft, right ribs under the liver 3cm, under the sword 3.5cm, soft. Mobility is negative. Knee tendon reflex decreased, Papanicolaou negative. Laboratory tests: blood; white blood cells 15 × 10 ~ 9 / L, neutral 0.72, lymph 0.28; red blood cells 4.2 × 10 ~ (12) / L, hemoglobin 120g / L. Creatinine 486.2