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患儿,女,2岁。因声嘶、憋气、口唇青紫2h 于1997年3月18日收住院。患儿当日上午因受凉出现声嘶,于中午12时声嘶加重,咳嗽、呕吐、突然憋气、口唇青紫,院外未作治疗,约10s 后症状稍缓解,此后反复多次憋气,口唇青紫,遂转来我院。入院查体:T36.5℃,P60/min,呼吸停止,神志不清,口唇青紫,心率60/min,心音低沉。立即让患儿吸氧,行环甲膜穿刺,自穿刺针头处行人工呼吸,5min 后自主呼吸建立,心率120/min,紫绀消失,然后行气管插管术,术中见喉腔内有大量分泌物及部分食物残渣,予以吸除,见声带充血、水肿,术后呼吸平稳,约25/min,心率130/min,约10min 后,呼吸停止,立即给人工呼吸器辅助,并给20%甘露醇125ml,5%SB10ml、氟美松5mg、可拉明0.375、洛贝林3mg、东茛菪碱0.3mg、速尿10mg 加西地兰0.2mg 加5%GS10ml。约7h 后,自主呼吸仍不恢复,心率160/min,左侧肺呼吸音低,行气管镜检查术,术中见气管内及左支气管内均有大量分泌物和食物残渣,及时予以吸出,约10min
Children, female, 2 years old. Due to hoarseness, suffocation, lips purple 2h on March 18, 1997 admitted to hospital. Children with hoarseness on the morning of the same day due to cold, hoarseness increased at 12 noon, cough, vomit, suddenly suffocating, lips purple, no treatment outside the hospital, about 10s after the symptoms ease slightly, then repeatedly repeated suffocation, lips bruising, then Turn to our hospital. Admission examination: T36.5 ℃, P60 / min, respiratory arrest, confusion, purple lips, heart rate 60 / min, low heart sound. Immediately to children with oxygen, line ring membrane puncture, self-puncture needle at artificial respiration, spontaneous breathing 5min after the establishment of heart rate 120 / min, cyanosis disappeared, and then tracheal intubation, intraoperative see a large number of throat Secretions and some food debris, to be sucked, see vocal cord congestion, edema, postoperative respiratory smooth, about 25 / min, heart rate 130 / min, about 10min, respiratory arrest, Mannitol 125ml, 5% SB10ml, dexamethasone 5mg, clomazone 0.375, Lobelin 3mg, scopolamine 0.3mg, furosemide 10mg plus cedilanid 0.2mg plus 5% GS10ml. About 7h later, spontaneous respiration still did not recover, the heart rate was 160 / min, the left lung sound was low, and tracheoscopy was performed. A large amount of secretions and food debris were found in the trachea and the left bronchus during operation, About 10min