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患儿男,36 h,因气促、面色青紫14 h入院。患儿系第1胎第1产,38+1周顺产,出生体重3200 g,1分钟Apgar评分10分,羊水Ⅱ°污染,胎盘及脐带未见异常。产前胎心快,胎动增多。母孕3-5个月时常“感冒”,未正规治疗。入院前14 h出现气促,不会吸吮, 需经汤匙喂吸。入院查体:T 36．5℃,P 136次／min,R 88次／min,体重3 200 g。头围34 cm．,身长48 cm。发育正常,营养中等,面色青紫,呼吸急促,前囟2．5 cm×2．5 cm。张力不高,口唇紫绀,轻微三凹征,双肺呼吸音粗,无干湿啰音。心律齐,心音有力,胸骨左缘Ⅲ-Ⅳ肋间隙可闻及2／6级收缩期杂音,局限,无传导。腹软,肝肋下0．5 cm,剑突下0．5 cm,质软,边锐, 脾肋下未及,脊柱四肢未见异常。生理反射可引出。血细胞分析:RBC 4．99×1012／L,HGB 202 g／L,WBC 17．9×109／L,L 39．5％,N 53．8％,M 6．7％,PLT
Children male, 36 h, due to shortness of breath, looking purple 14 h admission. The first fetus in children with first birth 38 + 1 weeks, birth weight 3200 g, 1 minute Apgar score 10, amniotic fluid Ⅱ ° pollution, no abnormalities in the placenta and umbilical cord. Prenatal fetal heart rate, fetal movement increased. 3-5 months pregnant mother often “cold”, not formal treatment. 14 h before admission, shortness of breath, will not suck, need to be fed by the spoon. Admission examination: T 36.5 ℃, P 136 times / min, R 88 times / min, weight 3 200 g. Head circumference 34 cm. , Length 48 cm. Normal development, moderate nutrition, looking bruising, shortness of breath, anterior fontanel 2.5 cm × 2.5 cm. Tension is not high, cyanotic lips, slightly concave signs of the three, the lungs breath sounds thick, dry and wet rales. Qi heart, heart sounds strong, the left sternal border Ⅲ-Ⅳ intercostal space can be heard and 2/6 systolic murmur, limitations, no conduction. Abdominal soft, liver ribs 0.5 cm, xiphoid 0.5 cm, soft, sharp edge, spleen and ribs under the spine, no abnormalities in the spine limbs. Physical reflection can lead to. Blood cell analysis: RBC 4.99 × 1012 / L, HGB 202 g / L, WBC 17.9 × 109 / L, L 39.5%, N 53.8%, M 6.7%, PLT