小儿腹泻双语班ppt.pptVIP

Healthy babies---Lovely 小儿腹泻Infantile Diarrhiea Pediatrics, Zhujiang hospital Southern medical college Fangsuzan方素珍 fangsuzan@ Request 要求 To master etiology, Clinical manifestations 掌握病因及临床表现 To master the diagnosis treatment? 掌握诊断和治疗 To understand the pathogenesis， the differential diagnosis懂得发病机制如何鉴别诊断 To understand the prevention 懂得如何预防 Case -1 A 6-month-old boy presented with a history of passing watery/ mucous stools 10+ times/d, vomiting 4-6times/d，distention, high grade fever for 6 days, and hadn’t urine , drinking, crying, eating in the last 6 hours. 患儿,男，6个月，反复发热伴腹泻6天 解水样便4-6次/日，3天后有粘液便，10+次/日 呕吐，腹胀，高热 不吃、不哭、不动、无尿6小时 case-1 Physical examination：T39 P200beats/min，deeply breath, Bp50/34, pale skin, coma, sunken eye sockets--- 呼吸深大，Bp50/34，浅昏迷，皮肤苍白，四肢末端凉，眼窝深陷 Blood check ：WBC 20.6， N85％ Stool check : WBC20/HP , RBC 30 /HP mucus serum check : K 1.6, Na 120, C l 87, Ca1.5, Mg0.5, pH 7.1, HCO310 , BE-18 Be treated in a private clinic 在诊所输液处理 The baby with severe diarrhea now is in the state of DIC, and is being rescued 重症腹泻后出现DIC正在急救中 analysis State： acute and severe 病情急重 GI symptoms : diarrhea/ vomit/ abdominal pain/ distension 呕吐、腹痛、腹胀、腹泻 Systemic symptoms: fever, coma, shock 全身中毒症状：发热，浅昏迷，休克症状 Dehydration and electrolyte disturbances changes of T / P /R/ Bp/ skin change of blood and stool tests 脱水：生命体征的变化，皮肤苍折，无尿，眼窝凹陷 水电紊乱：低渗.低K.低Na.低Ca.低Mg.酸中毒 diagnosis诊断 Acute infantile diarrhea小儿急性腹泻 severe hypotonic dehydration重度低渗性脱水 Metabolic acidosis代谢性酸中毒 Hypopotassaemia低钾血症 Hypocalcemia低钙血症 低氯血症 低镁血症 Short answer question Why diarrhea is so dangerous in children ? Dehydration electrolyte disturbances Shock and DIC Case-2 A 10-month-old girl has a history of diarrhea for 10 months. 10个月的女孩反复腹泻10个月 6-8 times stools daily Malnutrition, weight 5kg, length