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青海省海东属高海拨地区,大气氧含量低,婴幼儿重症感染均有低氧血症,酸中毒,易并发脑水肿.现将本人诊治及在省儿童医院进修期间收集的46例报道如下.1 临床资料①一般分析:男29例,女17例、年龄～1岁34例,～2岁8例,～3岁4例,最小年龄42天.②原发病:重症肺炎21例,毒痢13例,败血症8例,暴发型流脑4例.③临床表现:入院时体温不升3例,40℃以上超高热21例,其余均有不同程度发热;46例均有严重呼吸困难,呼吸频率增快17例,呼吸浅速,节律不齐或暂停28例,入院呼吸心跳骤停止1例;烦躁嗜睡交替11例,浅昏迷23例,昏迷12例,惊厥14例;肌张力增高22例;双侧瞳孔散大5例,缩小12例,忽大忽小24例,二侧瞳孔不等大5例,呕吐咖啡样物12例,严重腹胀5例,口鼻出血2例,皮肤出血点1例,甲臂微循环出血2例.
Haidong Qinghai Province is a high-altitude areas, low oxygen content in the atmosphere, severe infections in infants and young children are hypoxemia, acidosis, and complicated with cerebral edema. Now my diagnosis and treatment and Provincial Children’s Hospital during the training of 46 cases reported As follows.1 Clinical data ① General analysis: 29 males and 17 females, aged ~ 1 year old 34 cases, ~ 2 years old in 8 cases, ~ 3 years old in 4 cases, the minimum age of 42 days.② The primary disease: severe pneumonia in 21 cases , Poison dysentery in 13 cases, sepsis in 8 cases, fulminant meningitis in 4 cases.③ Clinical manifestations: admission to hospital temperature did not rise in 3 cases, more than 40 ℃ ultra-high fever in 21 cases, the rest have varying degrees of fever; 46 cases have severe breathing Difficulty, respiratory rate increased in 17 cases, shallow breathing, arrhythmia or pause in 28 cases, cardiac arrest stopped in 1 case; irritability sleepiness alternating in 11 cases, coma in 12 cases, 12 cases of convulsions, convulsions in 14 cases; Increased in 22 cases; bilateral mydriasis in 5 cases, reduced in 12 cases, sudden change in 24 cases, bilateral pupil unequal in 5 cases, vomit coffee samples in 12 cases, severe abdominal distension in 5 cases, nose and mouth bleeding in 2 cases, 1 case of skin bleeding, arm arm microcirculation bleeding in 2 cases.