16.RDS-HIE-IVH－全英班2010.3.ppt

Respiratory distress syndrome (RDS) Yuefang Huang (黄越芳) Department of Pediatrics First Affiliated Hospital Sun Yat-sen University Introduction Etiology Incidence Constituents of PS Functions of PS Hyaline membrane Hyaline membrane Clinical manifestation Chest retraction Laboratory examinations X-ray of RDS Severe RDS- white lung Echocardiography Differential diagnosis X-ray of Wet Lung Defect in the diaphragm X-ray of diaphragmatic hernia Infant of diaphragmatic hernia Treatment-General therapy I Treatment-General therapy II Treatment CPAP CPAP Treatment - CMV Conventional mechanical ventilation Pulmonary air leak PS replacement therapy PS replacement therapy PS treated RDS  Prevention  Etiology Pathological changes Lesions of HIE Pathogenesis Pathogenesis Clinical manifestation Clinical manifestation Diagnosis Diagnosis CT scanning of HIE Treatment-I Treatment-II Treatment-III Etiology and pathogenesis Where is germinal matrix ? 脑室室管膜下生发层的分布 Etiology and pathogenesis Etiology and pathogenesis Subdural hemorrhage (SDH) 硬脑膜窦图解(矢状面) Etiology and pathogenesis Clinical manifestation-I Clinical manifestation-II Clinical manifestation-III Periventricular- Intraventricular Hemorrhage Periventricular- Intraventricular Hemorrhage Primary Subarachnoid Hemorrhage(SAH) Intraparenchymal Hemorrhagel (IPH) Treatment-I Treatment-II Treatment-III Prevention Grading based on cranial ultrasound or CT scan Grade I: GMH (confined to GM- subependymal region) Grade II: Intraventricular hemorrhage(IVH) Grade III: Grade II + dilated ventricles Grade IV: Grade III + intraparenchymal hemorrhage CT ultrasound PVH IVH PVH-IVH Associated with birth trauma Post hemorrhage hydrocephalus (communicating or obstructive hydrocephalus) hemorrhage? liquefied? cyst formation? porencephalic cysts (脑穿通性囊肿) 1.Clinical effect 2.natural PS: Survanta synthetic PS: Exosurf 3.method: via endotracheal tube within 2h of life dosing: 2-4