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1 病历简介 患儿男,1岁3个月,阵发性咳嗽22天,加剧5天急症入院。患儿近22天来,突然呈阵发性咳嗽,呼吸困难,不发热,曾在当地县医院诊为“百日咳”治疗后好转。近5天又突然咳嗽加剧,有时口唇紫绀,住县医院经输液,吸氧治疗好转,准备出院时又突然呼吸困难,口唇严重紫绀而急转我院。入院时查体:患儿发育一般,营养较差,呈慢性衰竭病容,体温36℃,呼吸平稳,无鼻翼扇动,口唇轻度紫绀,双肺听诊呼吸音稍粗,其他无明显异常。胸透:心肺(-)。入院时询问患儿其母,无异物吸入史。初步诊断:气管异物?患儿入院又曾两次阵发性呛咳,重度呼吸困难,但均很快好转。次日行气管镜检查,在总气管内取出一粒完整的玉米粒。术后诊断:气管异物(玉米粒)。术后再次追问患儿其母得知,患儿在入院前22天曾玩过玉米。住院3天痊愈出
1 medical records Children with children, 1 year and 3 months, paroxysmal cough for 22 days, exacerbating the 5-day emergency admission. Children nearly 22 days, suddenly paroxysmal cough, difficulty breathing, no fever, had a local county hospital diagnosed as “whooping cough” after treatment improved. Nearly five days and suddenly increased cough, and sometimes cyanotic lips, live in the county hospital transfusion, oxygen therapy improved, and ready to discharge a sudden breathing difficulties, severe acute cyanosis and acute my hospital. Admission examination: children with general development, poor nutrition, was chronic failure disease, body temperature 36 ℃, stable breathing, no nose flap, lips mild cyanosis, lung auscultation breath sounds slightly thick, the other no obvious abnormalities. Chest throat: cardiopulmonary (-). When asked to ask the child’s mother admission, no foreign body history of inhalation. Preliminary diagnosis: tracheal foreign body? Children admitted to hospital had twice paroxysmal cough, severe breathing difficulties, but were quickly improved. The next day, bronchoscopy, remove a complete grain of corn in the total trachea. Postoperative diagnosis: tracheal foreign body (corn kernels). Asked again after the child’s mother learned that children had played 22 days before admission to play corn. 3 days hospitalized cured