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病史简介:女婴,7天。因全身皮肤黄染、频吐、腹胀而来门诊就医。其母在妊娠9个月时患重型肝炎,HBV标志检测HBsAg、HBeAg和抗—HBeIgM均阳性,分娩时因大出血而死亡。体检:发育营养较差,皮肤、巩膜中度黄染。颈软,心肺(-),肝肋下一指,质中,脾未及。腹部膨隆,腹水征(+),两下肢轻度浮肿。实验室检查:肝功能TTT12~u、TFT(+++)、谷丙转氨酶120~u,总胆红素13.68μmol/L.HBV标志检测(ELISA法),HBsAg、HBeAg、抗—HBelgM均阳性。诊断为先天性乙型肝炎。治疗3天因病情重死亡。剖腹见肝脏为棕黄色,表面肿胀。
History brief introduction: Baby girl, 7 days. Due to systemic skin yellow dye, frequent vomiting, abdominal distension outpatient treatment. His mother had severe hepatitis at 9 months of gestation, HBsAg was detected by HBV markers, HBeAg and anti-HBeIgM were positive, and hemorrhage was caused by childbirth. Physical examination: poor developmental nutrition, skin, sclera moderate yellow dye. Neck soft, cardiopulmonary (-), the next means liver ribs, quality, spleen and time. Abdominal bulging, signs of ascites (+), mild swelling of both lower extremities. Laboratory tests: liver function TTT12 ~ u, TFT (+++), alanine aminotransferase 120 ~ u, total bilirubin 13.68μmol / L.HBV markers (ELISA method), HBsAg, HBeAg, anti-HBelgM were positive . Diagnosis of congenital hepatitis B. 3 days treatment due to serious illness and death. Cesarean section to see the liver is brown, the surface swelling.