儿科学补液病例剖析题(国外英文资料).doc

儿科学补液病例分析题 1. Children, female, nine months, from diarrhoea with vomiting 4 days in hospital on October 28, vomiting, 4 days ago vomit for gastric contents 6-7 times/day, the second day of vomiting, diarrhea, stool more than 10 times/day, yellow liquid, more than quantity. I didnt pee for the first eight hours. Physical examination: T37 ℃ (R)/P150 time points R46 b/W 7.5 kg BP60/35 MMHG spirit Withers, pale and its response is poor, weak cry, acromegaly damp and visible pattern, the former fontanelle orbital sag, oral mucosa dry, two lung breath sounds clear, rhythm of the heart, no noise, abdomen flat soft, liver rib under 2 cm, skin elasticity bad, negative nervous system. Blood routine: Hb 130 g/L WBC7.7 x 109 / L N37 % stool routine: yellow paste WBC0-2 / Hp blood gas analysis: PH 7.25 BE - 10 tendency for Na + 128 L tendency tendency for K + 3.6 L/L issue: 1. Please write complete diagnosis. (2 points) 2, the most likely pathogenic bacteria (1 minute) 3, the first 24 hours rehydration (4 points) 1) acute enteritis (0.5) with severe hypotonic dehydration (0.5), metabolic acidosis (0.5), low blood capacity shock. (0.5) 2) pathogenic rotavirus is the most likely (1) (3) the first 24 hours of rehydration: 1. The expansion (1) : 2:1 isotonic sodium liquid 20 ml/kg 20 ml/kg/h static push 2. Cumulative loss (1) : 4:3:2 liquid sodium (2/3) (100-120 - ml/kg - 20 ml/kg) to cover two-thirds, allowance visual condition choose 8 to 10 ml/kg/h static drop this phase liquid drops in 8 ~ 12 hours after 3. Continue to yield loss (0.5) 2:3:1 sodium solution (1/2) 10 to 40 ml/kg 5 ml/kg/h static drop physiological requirements (0.5) of 60-80 - ml/kg of oral as far as possible, not oral use liquid sodium 4-1 (1/5) 5 ml/kg/h static drop this phase liquid drops in 12 ~ 16 hours after 4. Timely fill potassium, such as 6 hours no urine, urinary potassium supplement. The concentration of potassium chloride is no more than 0.3 percent. Surprise the calcium and magnesium. Check for bloo