【2017年整理】7.6新生儿颅内出血.pptVIP

儿科学 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 2 新生儿颅内出血 Iintracranial Haemorrhage of the newborn Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 3 新生儿颅内出血的病因 新生儿颅内出血的诊断及治疗 重 点 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 4 病因与发病机制 临床表现 诊 断 治 疗 预 后 预 防 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 5 病因与发病机制 早产 缺血缺氧 外伤(以产伤为主) 其他 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 6 早 产 32W早产儿 胚胎生发基质 未成熟 毛细血管网 血管壁仅有 一层内皮细胞 缺少胶原和 弹力纤维支撑 缺 氧 出 血 小脑软脑膜下颗粒层 脑室周围室管膜下 小静脉系统 易发生血流 动力学变化 血管壁破裂 室管膜下出血 脑室周围白质出血 脑室出血 血液外渗 毛细血管破裂 穿破室管膜 动脉压 呈“U”字形走向汇于Galen静脉 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 胚胎生发层基质示意图（水平面） 7 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 8 缺血缺氧 窒息缺氧 血管内压 低氧血症、高碳酸血症 脑内毛细血管缺血性损伤出血 脑内毛细血管破裂出血 动脉压 压力被动性血流 脑静脉血管破裂出血 静脉淤滞、血栓形成 脑血管扩张 动脉压 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 9 产 伤 其 他 胎位不正、胎儿过大、产程延长等使胎儿头部过分受压 高位产钳，胎头吸引器、急产、臀牵引等机械性损伤 频繁操作: 头皮静脉穿刺 吸痰、搬动、气管插管等 机械通气呼吸机参数设置不当 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 10 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 11 急 产 机制性损伤 天幕、大脑镰撕裂、脑表浅静脉破裂 硬脑膜下出血 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 12 新生儿凝血功能不足、肝功能不成熟 其他出血性疾病 母患原发性血小板减少性紫癜、孕期用苯妥英钠、苯巴比妥、利福平等药物 不适当输入高渗溶液(碳酸氢钠、葡萄糖钙、甘露醇等)→毛细血