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女婴,第1胎,足月,臀位足先露产。本村接生员接生。生后青紫窒息,经拍背、口对口吹气后有哭声及呼吸,抢救过程历时30分钟,未结扎脐带。抢救时抱起婴儿,体位高于胎盘10cm。胎盘娩出后体积肿大。以后发现患儿面色苍白,全身苍灰,软弱无力,四肢凉,呼吸浅弱,反应差,吃奶少,尿便正常,因病情不见好转于生后6天入院。家族中无遗传病史,母妊娠期与产后期均健康。入院查体:体温35.8℃,脉博128次/分,呼吸30次/分,体重3.4kg。皮肤粘膜苍白,无黄疸,口唇轻度发绀。两肺呼吸音清晰,心音低纯,心率128次/分,律整,心前区Ⅱ～Ⅲ级吹风样杂音。肝肋下0.5cm、脾未触及。脐带脱落,脐轮稍红肿,脐窝少许脓性渗出物,四肢肌张力低,拥抱及
Baby girl, first child, full-term, buttocks first exposed. The village birth attendance. After birth, purple asphyxiation, after beating back, mouth after blowing air to cry and breathe, the rescue process lasted 30 minutes, not ligation umbilical cord. Hold baby when rescue, position higher than the placenta 10cm. After the delivery of the enlarged placenta. Later found that children pale, the body gray, weak, cold limbs, weak breathing, poor response, less milk, urine will be normal, due to illness did not improve in 6 days after admission. No genetic family history of disease, maternal pregnancy and postpartum period are healthy. Admission examination: body temperature 35.8 ℃, pulse Bo 128 / min, breathing 30 beats / min, weight 3.4kg. Skin mucosa pale, jaundice, lips mild cyanosis. Breath sounds clear two lungs, heart sound low purity, heart rate 128 beats / min, law, precordial Ⅱ ~ Ⅲ grade hair-like noise. Liver ribs 0.5cm, spleen not touched. Umbilical cord off, slightly inflated umbilical cord, umbilical fossa a little purulent exudate, limb muscle tension is low, hug and