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患儿,男性,1天,39 2/7周。母孕期身体健康无手术及用药史。因早破水48小时而行剖宫产术,术中见脐带无黄染、胎盘无水肿,绒毛膜光整。患儿阿氏评分9分~10分~10分,生后即表现全身皮肤、粘膜苍白,下腹部、双下肢可见少许针尖大小出血点,因反应差、哭声弱转入儿科。查体:体温36.5℃,神志清,反应差,全身皮肤、粘膜苍白,前囟1.5cm×1.5cm,平坦,张力不高,双眼睑浮肿,心率140次/分,律齐,心音亢进,无杂音,脐带结扎,无渗血,肝肋下3cm可触及,脾未触及。拥抱反射、握持反射、觅食反射、吸吮反射均减弱,克氏征(+),巴氏征(+)。实验室检查:生后血常规:Hb45g/L,WBC11.7×10~9/L,N0.82,L0.18,PC130×10~9/L,BT、CT各2分,Rct0.12;血涂片示:有核红细胞(中幼、晚幼)占有核细胞的0.60,粒系有左移,成熟粒
Children, men, 1 day, 39 2/7 weeks. Pregnancy during pregnancy without physical and medication history. Broken for 48 hours due to premature cesarean section, umbilical cord surgery without yellow dye, no edema of the placenta, chorion smoothing. Children’s Ash score of 9 points to 10 points to 10 points after birth that the whole body skin, mucous membrane pale, lower abdomen, lower extremity can be seen a little needle-like bleeding point, due to poor response, crying weak into the pediatric. Physical examination: body temperature 36.5 ℃, clear consciousness, poor response, body skin, mucous membrane pale, bregma 1.5cm × 1.5cm, flat, tension is not high, double eyelid edema, heart rate 140 beats / min, law Qi, heart sound hyperthyroidism, Noise, umbilical cord ligation, no bleeding, liver ribs can be touched 3cm, spleen not touched. Hugging reflex, holding reflex, feeding reflex, sucking reflex weakened, Kirschner Sign (+), Pakistan’s sign (+). Laboratory tests: blood after birth: Hb45g / L, WBC11.7 × 10 ~ 9 / L, N0.82, L0.18, PC130 × 10 ~ 9 / L, BT, CT each 2 points, Rct0.12; Blood smear showed: nucleated erythrocytes (young, late young) accounted for 0.60 nuclear cells, granulocytes left shift, mature particles