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患儿,男,1 8/12岁。因感冒发热体温39℃在乡村医生处肌注病毒唑0.05g,柴胡1ml,体温未降,3小时后肌注地塞米松5mg,继之出现恶心呕吐,先后呕吐咖啡样物两次,解柏油样大便1次,前来就医。查体:T37℃、P110次/分、R30次/分,一般情况可,神萎,皮肤粘膜无异常,浅表淋巴结无肿大,咽充血,扁桃体Ⅰ°肿大,心肺阴性,腹平软,肝脾未及,肠鸣音8~10次/分,其余未见异常。化验:血常规:Hb80g/L、WBC8.0×10~9/L、N0.65、L0.35,大便潜血(?)。根据病史,考虑为:①地塞米松致急性胃溃疡并出血;②上感。给予禁食、止血敏、止血芳酸、西咪替丁及抗炎等治疗,1周后痊愈出院。讨论
Children, male, 1 8/12 years old. Fever due to flu 39 ° C at the village doctor intramuscular ribavirin 0.05g, Bupleurum 1ml, body temperature did not drop, 3 hours after dexamethasone 5mg, followed by nausea and vomiting, vomit coffee samples twice, the solution 1 stool like oil, come to seek medical treatment. Physical examination: T37 ℃, P110 beats / min, R30 beats / min, the general situation may be, atrophy, skin and mucous membrane without exception, superficial lymph nodes without swelling, pharyngeal congestion, tonsil I ° enlargement, cardio-pulmonary, , Liver and spleen not yet, bowel sounds 8 to 10 beats / min, the rest without exception. Laboratory: blood: Hb80g / L, WBC8.0 × 10 ~ 9 / L, N0.65, L0.35, fecal occult blood (?). According to medical history, considered as: ① dexamethasone induced acute gastric ulcer and bleeding; ② on the flu. Give fasting, bleeding sensitivity, hemostatic aromatherapy, cimetidine and anti-inflammatory treatment, 1 week after discharge. discuss