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患儿,男,8个月。因烦躁、呕吐、食欲减退3天住院。5天前开始服浓鱼肝油(每毫升含维生素A5万u、维生素D5千u),每天3 ml。2天后出现烦躁不安,精神食欲减退,频繁呕吐,继续服用鱼肝油,5日内共15 ml(含VitA 75万u),入院当天症状进一步加重,并发现前囱膨隆。病前一切正常,病后无抽搐、昏迷,亦无发热及皮肤粘膜出血。体检:体温37.1℃,脉搏112次,呼吸28次,体重9 Kg。发育营养良好,精神萎靡,前囱1.5×1.5cm,明显膨隆,张力增高,颈软,心肺(-),肝肋下3.5cm,脾未扪及,神经系统(-)。实验室检查:白细胞7.8×10~9/L,中性粒细胞0.25,淋巴细胞0.70,单核细胞0.05,血红蛋白110g/L,血小板250×10~9/L,GPT
Children, male, 8 months. Because of irritability, vomiting, loss of appetite 3 days hospitalization. Served 5 days ago, concentrated cod liver oil (vitamin A5000 u / ml, vitamin D5 thousand u), 3 ml per day. Two days later irritability, loss of appetite, frequent vomiting, continue to take cod liver oil, 5 days a total of 15 ml (including VitA 750,000 u), further aggravation of symptoms on the day of admission, and found that the former chimney bulging. All normal before the illness, no convulsions after the illness, coma, no fever and skin and mucous membrane bleeding. Physical examination: Body temperature 37.1 ℃, pulse 112 times, breathing 28 times, weight 9 Kg. Development of good nutrition, apathetic, before the chimney 1.5 × 1.5cm, obviously bulging, tension increased, neck soft, cardiopulmonary (-), liver ribs 3.5cm, the spleen is not palpable, the nervous system (-). Laboratory tests: white blood cells 7.8 × 10 ~ 9 / L, neutrophils 0.25, lymphocytes 0.70, monocytes 0.05, hemoglobin 110g / L, platelets 250 × 10 ~ 9 / L, GPT