Ryan C A, Gayle M
Pediatric Intensive Care Unit, University of Alberta Hospitals, Edmonton, Canada.
Pediatr Emerg Care. 1992 Jun;8(3):143-5. doi: 10.1097/00006565-199206000-00008.
An exclusively breast-fed infant, who did not receive vitamin K prophylaxis at birth, presented with signs of raised intracranial pressure. Her clinical course was compounded by a lumbar puncture, which revealed blood in the cerebrospinal fluid, and a large subgaleal hematoma, which developed at the puncture site of an attempted scalp vein catheterization, resulting in coning, hypovolemic shock, and death. A major coagulopathy was present, probably caused by vitamin K deficiency. The necessity for vitamin K prophylaxis in all newborns and the timing of lumbar puncture in the critically ill child are discussed.
一名纯母乳喂养的婴儿，出生时未接受维生素K预防治疗，出现了颅内压升高的症状。腰椎穿刺显示脑脊液中有血液，在尝试进行头皮静脉置管的穿刺部位出现了巨大的帽状腱膜下血肿，这使她的临床病情更加复杂，最终导致脑疝、低血容量性休克和死亡。患儿存在严重的凝血功能障碍，可能是由维生素K缺乏引起的。本文讨论了对所有新生儿进行维生素K预防的必要性以及危重症患儿腰椎穿刺的时机。
