患心肺疾病小儿做腰椎穿刺的危险

来源 :国外医学参考资料(儿科学分册) | 被引量 : 0次 | 上传用户:lyang1990x
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在国外的一些大医院里,虽然主要诊断已经明确,为了求全而不顾病人的安危,做一些不必要的检查。本文报告,1年内对有心肺疾病的3例患儿做了不必要的腰穿,结果发生死亡或接近死亡。例1 4个半月男孩,因腹泻和呕吐1天来急诊室。在4个月时,患咳嗽、发热及中耳炎。体温为38.1℃,呼吸规律。囟门软,眼外肌运动正常。心、肺和腹部检查正常。肌张力稍减低,吸乳能力良好,无拥抱反射,胸部X线检查正常。在急诊室饮水约30毫升后吐出,随即做腰穿。腰穿时婴儿心跳停止,抢救无效。死后剖检发现有急性广泛性坏死性心肌炎,轻度间质性肺炎,肺充血,脑血管充血伴少量出血点。 In some large foreign hospitals, although the main diagnosis has been made clear, in order to find out all patients regardless of the safety and to do some unnecessary checks. This article reports that in one year, 3 children with cardio-pulmonary disease had unnecessary lumbar puncture, resulting in death or near death. Case 1 4 and a half months boy, due to diarrhea and vomiting 1 day to the emergency room. At 4 months, she developed cough, fever and otitis media. Body temperature was 38.1 ℃, breathing patterns. Fontanelle soft, extraocular muscle movement is normal. Heart, lungs and abdomen were normal. Muscle tension decreased slightly, good breast pump, no hug reflex, chest X-ray examination was normal. About 30 ml of water in the emergency room after vomiting, then do waist wear. Waist to wear when the baby stopped heartbeat, rescue invalid. Post-mortem examination found that acute extensive necrotizing myocarditis, mild interstitial pneumonia, pulmonary congestion, cerebrovascular congestion with a small amount of bleeding.
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