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患儿,女,11个月,因呕吐四次,气促一天入院。三月前曾因上述症状在外院诊断为“支气管肺炎合并心力衰竭”住院治疗。体俭:体温37.4℃,呼吸50次,深快,发育正常,营养中等,精神差,面色苍白,鼻扇,口唇樱红,口周发绀。肋缘外翻,两肺呼吸音粗,偶可闻及少许干鸣。肝锁中线肋下4厘米,质软,脾未触及,四肢无畸形,膝反射存在。初步诊断:支气管肺炎。实验室检查:二氧化碳结合力10.2mEq/L,血钾2.5mEq/L,钠146mEq/L,氯化物115mEq/L,钙 1.86mEq/L,磷2.0mEq/L。血PH值=6.871,PCO_28.0mmHg,HCO_3~-1.5mEq/L,BE=-31.5mEq/L。尿PH值>6,尿比重1.018,尿糖定性(-)。尿常规:蛋白(+),白细胞4～6,红细胞0～2,管型2～4。胸部x线拍片:两肺纹理增多。
Children, women, 11 months, vomiting four times, shortness of breath one day admission. Three months ago because of the above symptoms in the outpatient hospital diagnosed as “bronchial pneumonia with heart failure” hospitalization. Thrifty: body temperature 37.4 ℃, breathing 50 times, deep fast, normal development, moderate nutrition, poor spirit, pale, nose fan, lip red lips, mouth, cyanosis. Flap edge valgus, two lungs coarse sound, even heard a little dry Ming. Liver lock midline rib 4 cm, soft, spleen not touched, limb deformity, knee reflex present. Preliminary diagnosis: bronchial pneumonia. Laboratory tests: Carbon dioxide binding capacity of 10.2 mEq / L, potassium potassium 2.5 mEq / L, sodium 146 mEq / L, chloride 115 mEq / L, calcium 1.86 mEq / L, phosphorus 2.0 mEq / L. Blood PH value = 6.871, PCO_28.0mmHg, HCO_3 ~ -1.5mEq / L, BE = -31.5mEq / L. Urine PH value> 6, urine specific gravity 1.018, urine qualitative (-). Urine: protein (+), white blood cells 4 to 6, red blood cells 0 to 2, tube type 2 to 4. Chest x-ray film: two lungs increased texture.