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患儿:男,42天,2.4 kg。第一胎,足月顺产,因咳嗽、喘憋、低热20天入院,按“肺炎”“先心病”治疗无效,摄 X 片示:右肺大片占位性病变,转入外科。体检:急性病容,反应弱,体温37.5℃,面色青灰,呼吸浅,36次/min,三凹征(+),右肺呼吸音极低,左侧呼吸音粗,心尖搏动明显左移。Hb14.1 g/L,WBC 31.8×10~9/L,GOT 600.1nmol·s~(-1)/L,肌酐53μmol/L,CO_2CP 23.35 mmol/L,甲胎蛋白(一),尿 VMA(一),X 线片示右上肺大片阴影,少量胸腔积液。CT 显示:右肺囊性病变4 cm×2cm×6.3 cm,右后纵膈囊肿3 cm×3 cm×3 cm。钡餐:食道僵直,无移位,中上段右缘轻度受压。术前诊断:先天性右肺囊肿,后纵隔肿物(性质
Children: male, 42 days, 2.4 kg. The first child, full-term follow-up, due to cough, wheezing, fever 20 days admitted, according to “pneumonia ” “congenital heart disease ” treatment ineffective, X-ray showed: large lesions of the right lung lesions into surgery . Physical examination: Acute illness, weak reaction, body temperature 37.5 ℃, pale gray, shallow breathing, 36 beats / min, three concave sign (+), right lung breath sounds very low, rough left breath sounds, apical beating significantly left. Hb 14.1 g / L, WBC 31.8 × 10 9 / L, GOT 600.1 nmol · s -1 / L, creatinine 53 μmol / L, CO 2 CP 23.35 mmol / L, A), X-ray showed a large shadow of the right upper lung, a small amount of pleural effusion. CT showed: right lung cystic lesions 4 cm × 2 cm × 6.3 cm, right rear mediastinal cysts 3 cm × 3 cm × 3 cm. Barium meal: Esophageal stiffness, no shift, the upper right margin of mild compression. Preoperative diagnosis: congenital right lung cysts, posterior mediastinum (nature