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例1 男,57d。以阵发性哭闹,面色苍白1d,拒乳12h之主诉入院。1d前无明显诱因出现阵发性哭闹,面色苍白,作呕吐3次,为胃内容物,量不多,呈喷射状。12h前出现拒乳,有时尖叫,烦躁易哭,颜面苍白明显,精神萎靡。病后无头部外伤史。既往体健,系1胎1产,足月顺产,生后无窒息。纯母乳喂养,奶量足。未肌注维生素K_1。查体:T37.0℃,P120次/min,R46次/min,Wt4.0kg。皮肤粘膜苍白,无黄染及出血点。头颅无畸形,未见瘢痕及包块。前囟1.5cm×1.5cm,后囟1.5cm×1.5cm,饱满,紧张。心、肺、腹无异常。神经系统检查:浅昏迷,双侧瞳孔等大等圆,直径2.5mm,对
Example 1 male, 57d. To paroxysmal crying, pale 1d, refuse to milk 12h of the main admission. No obvious incentive before 1d paroxysmal crying, pale, vomiting 3 times, as the stomach contents, small amount, was jet-like. 12h before emergence of refusal milk, and sometimes screaming, irritability, easy to cry, pale pale, apathetic. No history of head injury after the disease. Past physical health, the Department of 1 child 1 birth, term full-term, postnatal asphyxia. Pure breastfeeding, milk sufficient. Not intramuscular vitamin K_1. Physical examination: T37.0 ℃, P120 times / min, R46 times / min, Wt4.0kg. Skin mucous membrane pale, no yellow dye and bleeding points. No deformity of the skull, no scar and mass. Anterior fontanel 1.5cm × 1.5cm, posterior fontanel 1.5cm × 1.5cm, full, nervous. Heart, lung, abdomen without exception. Neurological examination: shallow coma, bilateral pupils and other large round, diameter 2.5mm, right