新生儿病例分析培训课件.pptVIP

Case1---historyThegirlwasborninBeijingobstetricsandGynecologyhospital.Themotherwasaprimiparaandpreviouslyhealthywithanuneventfulpregnancy.Theparentswerenonconsanguineous（无血缘关系的）.Spontaneouslabouroccurredingestationalage38weeks.Duetoslowprogress,greenamnioticfluid,polyhydramnion（羊水过多）,andapathologicalcardiotocography（分娩监护仪）,anacutecaesareansection（剖宫产）wasperformed.Apgarscoreswere3.6and9in1,5,and10minutes,respectively.Birhweightwas3,510g.K-vitaminwasadministered.Themotherremainedafebrileduringandafterdelivery.?Thechildhadanormalphysicalexamination,exceptfromapetechialrash(瘀点).Shewassuspectedforsepsisandstartedonpiperacillinsodiumandtazobactamsodium(特治星)andcefotaximesodium（头孢噻肟钠）.Abdominalultrasoundshowedanenlargedliverwithanormalstructure.Withinthefirst24hours,shebecameictericandwastransferredtospecializedneonatalcareinCapitalInstituteofPediatrics.

CTthoraxandabdomenhepatomegalyUScerebrumnormalCTcerebrumHaemorragiainposteriorfossaElectrocardiogramnormalLumbarpunctureWBC156/mm3RBC4/mm3Protein1800Glucose0.5Chloride121

Haemoglobin(range)9.5g/LLeucocytes（highest）46X109/LThrombocytes(lowest)21x1012/LCRP(highest)120g/dLBilirubintotal(highest)380μmol/LBilirubinconjugated(highest)50μmol/LALT(highest)205U/LALKALINEPHOSPHATASE(highest)456Lactatedehydrogenase1208UratenormalLactatenormalBloodculturegroupBstreptococcusBloodsmearnegative

Case1---questionsWHATISTHEDIAGNOSISOFTHEINFANT?WHATISTHEAETIOLOGYOFTHEDISEASE?HOWSHO