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患儿,男,4天。主因呼吸困难3天于1996年4月5日入院。患儿系孕足月第一胎第一产,因臀位剖宫产出生。生后无窒息史,生后15小时开奶,吸吮力可,生后约10小时排胎便,持续2天后转为黄色便。生后第2天出现气促、发憋,并进行性加重,吸氧后不见好转。入院前12小时呕吐咖啡状物1次,量约5ml,排暗红色血便1次,量约15ml,生后曾注射VitK,5mg。门诊以“新生儿肺炎”收入院。入院时查体:T35.4℃,R80次/分,P150次/分,体重3150g。烦躁口周发绀,前囟平,胸廓外观无畸型左肺呼吸音极低,心音低钝,在胸骨右缘听诊较响,心律规整,腹稍胀,肝在肋下3cm、剑下3cm、睥未触及,叩诊为鼓音,肠鸣音存在。四肢指趾端发绀,肌张力正常,新生儿反射存在。入院后急查血常规示:WBC 21.1×10~9/L,RBC4.66×10~(12)/L,Hb174g/L。血气分析:pH7.368,Pco_2 4.79kPa;Po_2 5.04kPa,ABE—4.
Children, male, 4 days. Mainly due to dyspnea three days in April 5, 1996 admission. Children with first full term pregnancy first birth, because of breech cesarean birth. After birth, no history of asphyxia, after birth 15 hours to open milk, sucking power can be, about 10 hours after birth row of stool will continue for 2 days after the yellow will. 2 days after birth, shortness of breath, hair hold, and progressive increase, no improvement after oxygen. 12 hours before admission, vomit coffee 1 times, the amount of about 5ml, dark red bloody stools row 1, the amount of about 15ml, after birth had injected VitK, 5mg. Out-patient to “neonatal pneumonia” income homes. Physical examination at admission: T35.4 ℃, R80 beats / min, P150 beats / min, weight 3150g. Irritability mouth week cyanosis, anterior fontanel level, thoracic appearance of non-deformity left lung breath sounds very low, low heart sound blunt, right auscultation in the sternal sound, rhythm of the heart, slightly swollen belly, the ribs in the ribs 3cm, 3cm under the sword Not touched, percussion drum sounds, bowel sounds exist. Extremities toe cyanosis, muscle tone normal, neonatal reflex exists. Routine blood examination after admission showed: WBC 21.1 × 10 ~ 9 / L, RBC4.66 × 10 ~ (12) / L, Hb174g / L. Blood gas analysis: pH7.368, Pco_2 4.79kPa; Po_2 5.04kPa, ABE-4.