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1病史摘要患儿,男,8岁。因急性左侧肢体偏瘫2d而入院。患儿入院前2d不明原因突然出现左侧肢体偏瘫,行走跛行。无发热、恶心、呕吐,无抽搐及昏迷。病后精神差,大水小便正常。无外伤史。体格检查:T37.2℃,P90次/min,R26次/min。神志清楚,皮肤无黄染。双侧瞳孔等大等圆,对光反射灵敏。颈无抵抗,咽充血、扁桃体无肿大。心音有力、律齐,无杂音,双肺呼吸音清晰,未闻及干湿性罗音。腹平软,肝、脾肋下未触及,左侧肢体偏瘫,左上肢肌力Ⅱ-Ⅲ级,左下肢肌力Ⅰ-Ⅱ级,右侧肢体肌力正常。生理反射存在,脑膜刺激征(-),巴彬斯基征(-)。实验室检查:血常规示WBC8.7×109/L,N0.62,L0.38,RBC4.3×1012/L,Hb120g/L。血液生化检查示血钾4.0mmol/L,血糖4.4mmol/L。
1 history Abstract children, male, 8 years old. Acute left limb hemiplegia 2d admission. 2d before admission to children with sudden unexplained left limb hemiplegia, walking limp. No fever, nausea, vomiting, convulsions and unconsciousness. The spirit of the disease is poor, normal urine urine. No history of trauma. Physical examination: T37.2 ℃, P90 times / min, R26 times / min. Conscious, skin yellow dye. Bilateral pupil and other large round, sensitive to light reflection. Neck non-resistant, pharyngeal congestion, tonsil enlargement. Strong heart sound, law Qi, no noise, clear lung breath sounds, no smell and wet and dry rales. Abdominal soft, liver, spleen ribs untouched, left limb hemiplegia, left upper limb muscle strength Ⅱ-Ⅲ level, left lower limb muscle strength Ⅰ-Ⅱ level, right limb strength normal. Physiological reflex exists, meningeal irritation sign (-), Babinski sign (-). Laboratory tests: blood showed WBC8.7 × 109 / L, N0.62, L0.38, RBC4.3 × 1012 / L, Hb120g / L. Blood biochemical tests showed potassium 4.0mmol / L, blood glucose 4.4mmol / L.