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患儿,男性.胎龄38周,于1997年6月9日9时30分臀位助产分娩,经过顺利,出生后无窒息,体重2500g,胎盘脐带无异常发现。生后当日晚喂奶时出现呛咳,乳汁从鼻腔流出。生后第2天新生儿精神差,拒奶,呼吸急促,口唇青紫,口吐白沫,体温38.5℃。双肺闻及湿性罗音,X线胸片示肺纹理增粗,有斑片状阴影,诊为吸入性肺炎。给予吸氧、补液、抗生素先锋霉紊治疗。生后第3天8点查房见新生儿除有上述临床表现外。腹部膨隆.呈进行性加重,呼吸困难。9点见腹部呈球形膨隆.腹壁静脉怒张,叩鼓音,肠鸣音消失,两侧阴囊亦嘭隆,皮肤透亮,行X线检查示腹腔内大量积气,胃泡影消失,膈肌升高。考虑有胃肠穿孔。即在局麻下
Children, men, gestational age 38 weeks, at 9:30 on June 9, 1997 breech midwifery childbirth, after a smooth, asphyxia after birth, weight 2500g, no abnormalities found in the umbilical cord of the placenta. Choking cough during feeding on the night after birth, milk from the nasal cavity outflow. After birth, the first two days of poor neonatal, refused to milk, shortness of breath, bruising lips, foaming at the mouth, body temperature 38.5 ℃. Lung smells and wet rales, X-ray showed thickening of the lungs, patchy shadows, diagnosed as aspiration pneumonia. Give oxygen, rehydration, antibiotic pioneer mildew treatment. On the third day after birth 8:00 check-in see newborns in addition to the above clinical manifestations. Abdominal swelling. Was progressive increase in breathing difficulties. 9:00 to see the abdomen was bulging bulge.Vaginal vein engorgement, percussion drum sound, bowel sounds disappear, both sides of the scrotum also Long, skin translucent, X-ray examination showed a large number of intraperitoneal Qi, disappearance of gastric bubble, diaphragm elevation . Consider gastrointestinal perforation. Under the local anesthesia