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患儿,男,3天,因反应差3天,呼吸困难,面色苍白8小时入院。系1胎1产,40+1周孕,剖宫产。Apgar评分1分钟、5分钟、10分钟分别评8分、10分、10分,生后反应较差,呼吸尚平稳,吃奶少,无抽搐,24小时排胎粪。入院前8小时,患儿突然出现呼吸急促,面色苍白、拒乳,急送我院。查体:体温36℃,脉搏们不清,呼吸78次/分,血压测不出,体重2.1公斤。浅昏迷状,呼吸急促,面色苍白,四肢凉。前囱平软,双肺呼吸音粗糙。心率200次/分以上,心音低钝,各瓣膜听诊区未闻及杂音。腹软,肝脏肋下2cm,质软,脾脏肋下未及。四肢肌张力低,原始反射消失。入院诊断:1、心动过速并心源性休克,2、新生儿肺炎;3、足月小样儿。急作心电图为室性心动过速立即予吸氧、利多卡因4mg加入10%葡萄糖10 mL缓慢推注,速度 1mL/min,推到5mL时,心电图转为窦性心率。其
Children, male, 3 days, due to poor response 3 days, breathing difficulties, pale 8 hours admitted to hospital. Department of a fetus 1 births, 40 + 1 weeks of pregnancy, cesarean section. Apgar score 1 minute, 5 minutes, 10 minutes were rated 8 points, 10 points, 10 points, poor response after birth, breathing is stable, less milk, no convulsions, 24 hours row of meconium. 8 hours before admission, the child suddenly appeared shortness of breath, pale, refused to milk, urgently sent to our hospital. Physical examination: body temperature 36 ℃, pulse are unclear, breathing 78 beats / min, blood pressure can not be measured, weight 2.1 kg. Shallow coma, shortness of breath, pale, cold limbs. Front chimney soft, rough lung breath sounds. Heart rate 200 beats / min or more, low heart sound, the valve auscultation area did not smell and noise. Abdomen soft, ribs under the liver 2cm, soft, spleen and ribs did not. Limb muscle tension is low, the original reflex disappears. Admission diagnosis: 1, tachycardia and cardiogenic shock, 2, neonatal pneumonia; 3, full-term baby sample. Emergency electrocardiogram ventricular tachycardia immediately to oxygen, lidocaine 4mg 10% glucose 10 mL bolus, the speed of 1mL / min, pushed to 5mL, ECG to sinus heart rate. its