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患儿男,3天。新法接生,无窒息史。生后12h开奶,24h后见其周身发绀,以“先天性心脏病”收入院。患儿父母健康,无服药及化学药物接触史。查体:T36.5℃,P120次/min;R36次/min。营养、发育及精神状态良好。周身皮肤明显发绀,呼吸平稳,心、肺听诊正常,肝、脾未触及。末梢血像正常。采血时血呈乌黑色,亚硝酸盐鉴定试验阳性。初步诊断:高铁血红蛋白血症。速给美蓝4mg,加入5％葡萄糖液40ml中静滴,5min后青紫消失,皮肤转红润,继给维生素C0.5g加于5％葡萄糖液20ml中静点,继续观察6d,全身情况良好,临床痊愈出院,随访半年。一切正常。
Children male, 3 days. New law delivery, no history of suffocation. 12h after birth, milk, see the whole body cyanosis 24h, “Congenital heart disease” income hospital. Children with healthy parents, no medication and chemical exposure history. Physical examination: T36.5 ℃, P120 times / min; R36 times / min. Nutrition, development and mental well. The skin was obviously cyanosis, stable breathing, heart, lung auscultation normal, liver, spleen not touched. Peripheral blood as normal. Blood was black blood black, nitrite identification test was positive. Preliminary diagnosis: methemoglobinemia. Speed to methylene blue 4mg, add 5% glucose solution 40ml in the intravenous drip, 5min purple disappeared, the skin turns ruddy, following the vitamin C0.5g plus 5% glucose solution 20ml in the static point, continue to observe 6d, the general condition is good, Clinical recovery was followed up for six months. everything is normal.