患儿男,1天,系5胎2产,出生体重3kg。因孕母患先天性心脏病、心功能不全伴胎儿宫内窘迫,故行剖宫产分娩,出生后窒息,经抢救后呼吸平稳。于生后24h突然呕吐咖啡色粘液约20ml,以胃管抽出咖啡色液体15ml,用生理盐水加肾上腺素1mg洗胃。查体:体温35.8℃,呼吸45次/min,脉搏130次/min。精神差,反应可,囟门平、全身皮肤、巩膜轻度黄染,口周无紫绀,双肺呼吸音略粗,未闻及干湿性罗音。心律齐,各瓣膜听诊区未闻及杂音。腹部检查无异常。血像:Hb195g/L,WBC15.5×10~9/L,RBC5.29×10~(12)/L,血K~+4.22mmol/L,Na~+129.9mmol/L,尿素氮6.6mmol/L,CO_2CP23.7mmol/L,Coomb’s试验直接、间接均阴性,GPT<30u/L。尿(-),大便潜血弱阳性。生后38h因上消化道出血行纤维胃镜检查:食道通过顺利,中上段广泛性糜烂,充血,散在小出血点;胃底粘膜光滑,见粘液呈咖啡色,胃体散在斑片状糜烂伴出血点,周围粘膜 Children male, 1 day, 5 fetuses 2 births, birth weight 3kg. Because pregnant women suffer from congenital heart disease, cardiac insufficiency with fetal distress, so cesarean section delivery, postpartum asphyxia, after resuscitation, stable breathing. Suddenly vomit brownish mucus about 24h after birth, take gastric juice out of brown liquid 15ml, with saline plus epinephrine 1mg gastric lavage. Physical examination: body temperature 35.8 ℃, breathing 45 times / min, pulse 130 beats / min. Poor spirit, the reaction can be, Fontanelle, the body skin, scleral mild yellow dye, no cyanosis of the mouth, lung breath sounds slightly coarse, unheard-of and wet and dry rales. Qi heart, the valve auscultation area did not smell and noise. Abdominal examination without exception. Blood: Hb195g / L, WBC15.5 × 10 ~ 9 / L, RBC5.29 × 10-12 / L, blood K +4.22mmol / L, Na129.9mmol / L, urea nitrogen 6.6mmol /L,CO_2CP23.7mmol/L, Roomb’s test were direct and indirect negative, GPT <30u / L. Urine (-), fecal occult weak positive. 38h after birth due to upper gastrointestinal bleeding fibrinoscopy: esophageal smooth, the upper part of the extensive erosion, congestion, scattered in the small bleeding point; gastric mucosa smooth, see the mucus was brown, gastric scattered patchy erosion with bleeding , Around the mucous membrane