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1 病例介绍 患儿,女,出生1d,体重3.5kg,第1胎第1产,超预产期3w出生。出生前1w羊水已破,进入第2产程时已有宫内窘迫,胎心音低,经产钳助产,生产时无哭声,苍白窒息,即刻A PGar,评分1分,肌张力零,心率98次/min,即行人工呼吸,拍足底,肌注尼可刹米、洛贝林、吸氧等抢救后,方有浅微哭声,浅表而不规则的呼吸,肌张力仍低,刺激后眉微动,口周及肢端紫绀,转入儿科病房。检查T37℃、P120次/min,R56次/min,神志欠清,反应差,面色苍白,口唇三角区发绀,气促伸吟,头颅无血肿,前囟平坦,巩膜皮肤无黄染,两肺呼吸音粗,无干湿性罗音,心率120次/min,律齐,心音低,无杂音,腹平软,肝肋下约1.5
1 case description Children, female, born 1d, weight 3.5kg, the first birth of the first child, 3w birth is beyond the expected date of birth. Amniotic fluid 1w before birth has been broken into the second stage of labor has been intrauterine distress, fetal heart sound low, midwifery midwifery, production without crying, pale asphyxia, immediately A PGar, score 1, muscle tone zero, heart rate 98 times / min, that is, artificial respiration, shoot the foot, intramuscular injection of Nicotem, Lobelin, oxygen and other rescue, the parties have a slight cry, superficial and irregular breathing, muscle tension is still low, After the stimulation eyebrow fretting, perioral and acral cyanosis, into the pediatric ward. Check T37 ℃, P120 times / min, R56 times / min, lack of consciousness, poor response, pale, triangular cyanotic lips, shortness of breath stretch, head no hematoma, flat anterior bland, scleral skin without yellow dye, both lung Breath sounds coarse, no wet and dry rales, heart rate 120 beats / min, law Qi, low heart sound, no noise, abdominal soft, liver ribs about 1.5