英新生儿窒息与新法复苏-豆柴文库

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会计学NeonatalAsphyxiaanditsNewConceptonResuscitationNewWords

pregnantwomaninvalid
Apgarscoreumbilicalcord
primaryapneaasynersis
HIE(hypoxic-ischemicencephalopathy)
ICH(intracranialhemorrhage)
MOD(multipleorgansfunctiondamage)
hypercapniahypoxemiaNeonatalasphyxiaisakindofgasexchangedisorder,thatcouldcausehypoxemia,hypercapniaandmetabolismacidosis,whichisaccountedonthatnewbornhasnoautorespirationoronlyhasirregular,intermittentandfeeblerespirationatbirth,orpresentrespiratorydepressionafterbirth.
It’sincidenceisabout5%occupiedtheviablebirth,andcancause20%deathintoltalnewnataldeath.
Thenatureofasphyxiaitselfishypoxia.
UsuallyweadoptApgarscoretojudgethedegreeofasphyxiation.AsphyxiacouldcausenotonlyHIE,butalsoMOD,andistheoneoftheimportantcausesofdeath,dysnoesiaandinvalid(cerebralpalsy)innewbornsallovertheworld.Neonatalmortalityisabout19.0‰(2005)inourcountry.Thefirstthreedeathcausesareprematurebirth&lowbirthweight,asphyxiaandpneumonia.
Thereare1millionnewborndeathcausedbyneonatalasphyxia(total4millionyearly-2005.WHO),and>1millionneonatessufferfromdysnoesia,cerebralpalsyandotherdeformitycausedbyittoo.placentapraeviashortcord胎儿因素suckingfetalheadPathophysiologyBlockedswitchofrespiration&circulationfromfetustonewbornHypoxia-ischemiaalterindifferenceorgansasasphyxiaBreathalter
1．PrimaryapneaWhenhypoxia,thebabymaybreathdeeplyandquicklyatfirstl-2mins,ifnomanagementintime,itmayoccurbreathinhibitionandreflectiveheartratedecreasinginashorttime.．
2．SecondaryapneaIfthehypoxiapersistence,thebabymayoccurgaspingrespiration,heartratecontinuestepdown,theBPbegintodescend,musculartensionlost,thebabyispaleandrespiratorymovementasynersis,hemayoccuradeepgaspatlastandthenenterthesecondaryapnea.(needpositivepressure)/bloodgasPaCO2↑，PH&PaO2↓mixedacidosis

Glucosemetabolicdisorder
catecholamine&glucagonreleaseearly↑→bloodsugarnormalor↑thenglycogendepletion,bloodsugar↓

Hyperbilirubinemia
Bilirubincombinewithalbumin↓、thevigorofliverenzyme↓→unconjugatedbilirubin↑

Hyponatremiaatrialnatriureticpeptide,A