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婴儿,女,70天。因气喘伴轻度呼吸困难30天,出现严重呼吸困难3小时入院。患儿足月顺产,出生后发现颈前有1小肿物,无症状。1月来出现气喘伴呼吸困难,哭闹时口唇青紫,但无发热、咳嗽。在外院诊断不明,治疗无效。3小时前症状加剧,急转我院。查体:T37℃,P140次/min,R40次/min,神志清楚,呼吸急促,鼻翼扇动,口唇青紫,三凹征明显。头后仰位颈前可触及一肿物,大小3×3cm,质硬,表面光滑,可移动。胸廓无畸形,心肺正常,神经系统无特殊。氯胺酮麻醉下手术。取颈前横切口先行气管切开,后解剖分离肿物,见肿物位于左甲状腺叶,大小3×3×3cm,质
Baby, female, 70 days. Due to asthma with mild dyspnea for 30 days, severe dyspnea occurred for 3 hours after admission. The child had a full term delivery, and after birth, a small mass was found in front of the neck and was asymptomatic. Palpitation and dyspnea occurred in January, cyanosis when crying, but no fever or cough. The diagnosis was unknown in the external hospital and the treatment was ineffective. Symptoms worsened three hours ago and I was transferred to our hospital. Physical examination: T37°C, P140 beats/min, R40 beats/min, conscious, shortness of breath, nostril flapping, lips cyanosis, three concave sign. The head of the head can reach to the front of the neck and can reach a mass of 3×3cm. It is hard and has a smooth surface and can be moved. Thoracic no deformity, normal heart and lung, no special nervous system. Ketamine surgery under anesthesia. Take anterior transverse incision of the neck for tracheotomy, and dissect the mass after dissection. See tumor in the left thyroid gland, size 3×3×3cm.