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腹瀉導致遲發型新生兒出血性疾病併發顱內出血：一病例報告
Late Hemorrhagic Disease of the Newborn with Intrcranial Hemorrhage Associated with Intractable Diarrhea-A Case Report
摘要
個案是一十週大嬰兒因持續二週腹瀉，突然出現局限型抽搐、臉色蒼白、意識昏迷，經腦部斷層掃描檢查發現自發性顱內出血。經檢查血液凝血機能，因而發現有血液凝固病變（PT、PTT皆呈明顯延長）。經靜脈維生素K₁注射，結果迅速使血液凝固病變恢復正常，因而診斷遲發型新生兒出血性疾病，並於翌日進一步接受開顱手術治療並取出血腫塊。對於出生之新生兒立旣接受預防性維生素K的使用，早已證實可預防早發性與典型之新生兒出血性疾病，但對於有維生素K缺乏疑慮之高危險群嬰幼兒，如本個案罹患慢性腹瀉等危險因素，重複投予維生素K的考量則有其必要性，更是現行的公共衛生政策應用再被重視的課題。
並列摘要
We described a 10-week-old infant with intractable diarrhea for more than 2 weeks developed pale, focal seizure with conscious change and spontaneous intracranial hemorrhage. Coagulopathy with prolong PT、PTT was found and then was corrected after vitamin K infusion. Late hemorrhage disease of the newborn (LHDN) was diagnosed and he underwent craniotomy with removal of hematoma. The causes of LHDN in this case are considered secondary to malabsorption of vitamin K caused by intractable diarrhea. Neonatal administration of vitamin K prevents early and classic hemorrhagic disease of the newborn has been well recognized. Furthermore, in order to eradicate primary and secondary LHDN, vitamin K prophylaxis should be designed to be effective all in newborn period and in infancy.
延伸閱讀
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