论文部分内容阅读
患儿女,10天,足月顺产。因不吃不哭5天入院。体检:肛温31℃,体重2.7kg,呼吸浅表,有屏气,反应迟钝。面部有水肿,两肺呼吸音粗,心率100次/分,心音低钝,四肢末端红肿发凉。胸片提示双侧肺炎,经暖箱保暖、抗感染、支持疗法,半月后胸片所见肺炎影吸收。但体温不稳定,四肢凉。生后27天出暖箱,体温低于35℃,吃奶少,吞咽缓慢,嗜睡,少动,面色较苍白,眼睑水肿,皮肤粗糙,腹膨大有轻度脐疝,呕吐。疑先天性甲状腺功能减低(下称甲低),即查血T_4 (CPBA法)<4μg/dl(正常参考值5～13μg/dl),FT_4Ⅰ<3.5μg/dl(正常参考值5～13μg/dl)。T_3摄取(MAA法)吸收比值0.88(正常0.82～0.98),TSH58.0μu/ml(正常0～
Children with children, 10 days, full-term delivery. Do not eat because of crying 5 days admitted to hospital. Physical examination: rectal temperature 31 ℃, weight 2.7kg, shallow breathing, breath holding, unresponsive. Facial edema, coarse breath sounds of both lungs, heart rate 100 beats / min, heart sounds low blunt, extremities inflamed redness. Chest radiograph prompted bilateral pneumonia, warm box warm, anti-infection, supportive therapy, chest pain after half a month to see the absorption of pneumonia shadow. But the body temperature is unstable, cold limbs. 27 days after birth out of the warm box, body temperature below 35 ℃, less milk, swallowing slowly, drowsiness, less moving, looking pale, eyelid edema, rough skin, swollen belly slight umbilical hernia, vomiting. Suspected congenital hypothyroidism (hereinafter referred to as hypothyroidism), namely blood test T 4 (CPBA method) <4μg / dl (normal reference value 5 ~ 13μg / dl), FT_4I <3.5μg / dl (normal reference value 5 ~ 13μg / dl). T_3 ingestion (MAA) absorption ratio of 0.88 (normal 0.82 ~ 0.98), TSH58.0μu / ml (normal 0 ~