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患婴,男,20分钟。第一胎第一产,41+3周,因羊水过少、Ⅲ°混浊难产出生。出生时皮肤粪染,1分钟Apgar评分3分,予气管插管,吸出粘稠胎粪约1ml,基本吸净后予复苏囊正压呼吸及系列复苏,5分钟,Apgar评分6分,继续复苏囊正压通气15分钟,肤色无改善,转入NICU。体检:体温32℃,心率120次/分,呼吸 30次/分,体重2700g。皮肤发绀,胸廓饱满,左肺叩诊过清音,无呼吸音。右肺 闻及粗湿罗音。心音遥远,低钝。查动脉血 气分析:pH 6.826,PCO2 12.88kPa,PO2 3.11kPa,HCO3-17.2mmol/L,BE-30.9mmol/L。
Infant, male, 20 minutes. The first birth of the first child, 41 +3 weeks, due to oligohydramnios, Ⅲ ° turbid dystocia was born. Skin feces at birth, 1 minute Apgar score of 3 points, to the endotracheal tube, suck the sticky meconium about 1ml, the basic net absorption of resuscitation capsule positive pressure breathing and series of recovery, 5 minutes, Apgar score 6, continue to recover Positive pressure ventilation balloon 15 minutes, no improvement in color, transferred to the NICU. Physical examination: body temperature 32 ℃, heart rate 120 beats / min, breathing 30 beats / min, weight 2700g. Skin cyanosis, full thorax, left lung percussion over the voiceless, no breathing sound. Right lung smells and wet rales. Heart sounds far, low blunt. Check arterial blood gas analysis: pH 6.826, PCO2 12.88kPa, PO2 3.11kPa, HCO3-17.2mmol / L, BE-30.9mmol / L.