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男,11月龄。呼吸困难3日入院。入院检查:患儿发育差,软腭裂,咽后壁右侧一暗紫色赘生物约5×1.5×1.5cm。触诊质韧,表面光滑,无搏动,蒂部较细,其附着于鼻咽部右后上方。追问病史,患儿足月,顺产,分娩后新生儿窒息,经给氧等积极抢救后好转,在院行鼻饲1周。回家后吸吮常发生憋气,面部紫绀,休息片刻可缓解。近来呼吸困难加重,3月前渐不能平卧,平卧则憋气,张口呼吸只能俯卧位,头偏向左侧。行颅底“CT”扫描,患儿呼吸困难不能安静入睡,图像不清。拟诊:鼻咽部息肉、附耳。治疗:血管钳挟持赘生物,用扁桃体圈套器绞套摘除右鼻咽部肿块,根蒂部有少许渗
Male, 11 months old. Dyspnea admitted to hospital on the 3rd. Admission examination: poor development of children, soft palate, pharynx posterior wall of a dark purple vegetation about 5 × 1.5 × 1.5cm. Touchable quality and tough, smooth surface, no beats, pedicle thinner, attached to the top right nasopharynx. Asked the medical history, full-term children, spontaneous abortion, neonatal asphyxia after delivery, oxygen and other positive rescue improved, nasal feeding in the hospital for 1 week. Suffocation often occurs after going home suffocating, facial cyanosis, rest for a moment to ease. Recently, dyspnea increased, gradually less than 3 months before lying, supine, suffocating, mouth breathing can only prone position, head to the left. Skull base “CT” scan, children with dyspnea can not sleep quietly, the image is not clear. To be diagnosed: nasopharyngeal polyps, with ear. Treatment: vascular forceps hostage of vegetation, removal of the right nasopharyngeal mass with tonsil sheath twist sets, pedicle a little permeability