患者,女,生后d25下午四时许,突然出现呼吸困难,以吸气性呼吸困难为主,并出现典型的喉喘鸣音及阵发性青紫,曾在当地给予鲁米那、安定肌注,症状仍不见缓解,急诊以“呼吸衰竭”收入院。入院时体检:体重3.5kg,身长51.5cm,头围34cm,胸围32.5cm,前囟2.0cm×2.0cm,平坦,颈软。体温36.6℃,呼吸38次/min,脉搏128次/min。机体反应极差,拥抱,觅食、吸吮、握持反射均消失,面色青紫、气促,三凹征明显。口唇及鼻孔无泡沫样分泌物。皮肤弹性尚可,不多汗。心音纯节律整,心率128次/min。两肺听诊为散在喘鸣音,无湿罗音。无肌肉颤动。瞳孔缩小如针尖大小,对光反射明显减弱。实验室检查:白细胞2.7×10~(10)/L,淋巴31％,分叶69％,红细胞 Patients, women, after birth d25 4 o’clock in the afternoon, a sudden onset of dyspnea, mainly aspirated dyspnea, and typical throat wheezing and paroxysmal bruising, once in the local administration of luminal, stable muscle Note, the symptoms still eased, emergency to “respiratory failure” income hospital. Physical examination on admission: Weight 3.5kg, length 51.5cm, head circumference 34cm, chest circumference 32.5cm, bregma 2.0cm × 2.0cm, flat, neck soft. Body temperature 36.6 ℃, breath 38 times / min, pulse 128 beats / min. Very poor response to the body, hugging, feeding, sucking, holding reflex disappeared, looking bruising, shortness of breath, three concave signs obvious. No foam-like secretions on lips and nostrils. Skin elasticity is acceptable, not sweat. Heart sound pure rhythm, heart rate 128 times / min. Auscultation of both lungs for scattered wheezing, no wet rales. No muscle fibrillation. Pupil narrowing, such as the size of the tip of the light reflection was significantly reduced. Laboratory tests: leukocytes 2.7 × 10 ~ (10) / L, lymphatic 31%, leaf 69%, red blood cells