英新生兒窒息與新法復(fù)蘇(已修改)
2025-06-07 18:19 本頁面
【正文】 Neonatal Asphyxia and its New Concept on Resuscitation Chongmin Xu Union Hospital New Words pregnant woman invalid Apgar score umbilical cord primary apnea asynersis HIE ( hypoxicischemic encephalopathy) ICH (intracranial hemorrhage) MOD (multiple ans function damage) hypercapnia hypoxemia ? Neonatal asphyxia is a kind of gas exchange disorder, that could cause hypoxemia, hypercapnia and metabolism acidosis, which is accounted on that newborn has no auto respiration or only has irregular, intermittent and feeble respiration at birth, or present respiratory depression after birth. ? It’s incidence is about 5% occupied the viable birth,and can cause 20% death in toltal newnatal death. ? The nature of asphyxia itself is hypoxia. ? Usually we adopt Apgar score to judge the degree of asphyxiation. ? Asphyxia could cause not only HIE, but also MOD, and is the one of the important causes of death, dysnoesia and invalid (cerebral palsy) in newborns all over the world .Neonatal mortality is about ‰ (2022) in our country. The first three death causes are premature birth amp。 low birth weight, asphyxia and pneumonia. ? There are 1 million newborn death caused by neonatal asphyxia (total 4 million yearly2022. WHO), and 1 million neonates suffer from dysnoesia, cerebral palsy and other deformity caused by it too. Delivery factors Placenta factor Fetal factor umbilical cord factor Pregnant woman Asphyxial etiopathogenisis too older or young Respiratory disease cardiac disease severe anaemia Smoking amp。 drug gestational hypertension Pregnant woman factor polycyesis diabetes placenta praevia placental abruption infarctus ageing Placenta factor short cord knot of umbilical cord umbilical hang down umbilical cord circle neck Umbilical factor 胎兒因素 premature large for date infant intrauterine infection respiratory tract obstruction congenital cardiopathy congenital abnormality foetus factor sucking fetal head forceps aid deliver breech presentation unsuitably use drugs in labor labor extension amp。 precipitate labor cephalopelvic disproportion deliver factor Pathophysiology ? Switch of respiration amp。 circulation from fetus to newborn are blocked ? Breath alter ? biochemistry amp。 metabolism alter in blood fetal pulmonary fluid is removed from lungs ↓ surface active substance(SAS) secretes ↓ functional residual capacity of alveolus set up ↓ pulmonary circulation
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