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患儿男,8个月。生后母乳喂养。首次食稀释全脂年奶粉约120ml,食后20分钟,突然面色苍白、哮喘、呼吸困难,腹泻,急诊入院。发病前患儿健康,未进食其他食物,但易患呼吸道感染或湿疹。其母孕期有食牛奶后皮肤发痒、荨麻疹史。查体:神志清楚,面色苍白,烦躁不安,呼吸困难、鼻扇,口周重度发绀,颜面部可见血管神经性水肿,全身皮肤见多处大片风团块,皮下有出血点,四肢末端发凉。心率快,肺部闻及哮鸣音。立即给氧,皮下注射1:1000肾上腺素O.3ml,非那根?mg肌肉注射,静滴葡萄糖和地塞米松4mg。配合刺激咽部催吐,吐出含牛乳的胃
Children male, 8 months. After birth breastfeeding. The first meal of diluted whole milk powder about 120ml, 20 minutes after eating, suddenly pale, asthma, dyspnea, diarrhea, emergency admission. Children before the onset of health, did not eat other foods, but susceptible to respiratory infections or eczema. The mother had milk after iturized itchy skin, urticaria history. Physical examination: conscious, pale, irritable, dyspnea, nose fan, severe cyanosis around the mouth, visible facial neurovascular edema, systemic skin see a number of large wind clumps, subcutaneous bleeding point, extremities cold . Fast heart rate, lung smell and wheeze. Immediately oxygen, subcutaneous injection of 1: 1000 epinephrine O.3ml, phenanthrene? Mg intramuscular injection, intravenous glucose and dexamethasone 4mg. With the stimulation of pharyngeal emetic, spit out the milk-containing stomach