新生儿呼吸困难.pptxVIP

会计学;病因 分三类 肺部疾病 RDS、TTN、MAS、肺气漏、肺炎、 肺出血、肺发育不良、慢性肺 部疾病 气道及肺阻塞性疾病 气道阻塞（喉气管软 化）、肺受压（膈疝） 非肺部疾病 先心、心功能不全、贫血、多 血、低体温、窒息后 ; 病史注意点 妊娠周龄 母亲情况 糖尿病 产前大出血 宫内生长迟缓 多胎妊娠 感染史（羊膜早破、母亲发热） 以往RDS史 胎儿窘迫、脐血pH、复苏情况 体检注意点 胎龄评估, 紫绀情况, 呼吸困难严重度, 呼 吸节律、呼吸次数, 全身情况（灌注, 心功 中枢） ;治疗原则 氧疗 CPAP及机械通气 Fio20.5 才能维持PaO2 50mmHg 开放气道及气道物理治疗 置于中性环境温度，维持正常体温 容量及心功能维持 液体需24小时匀速输入 抗菌素治疗 病因学诊断 胸部X光片、血细胞计数、血气 血培养、透光试验 ;Pulmonary causes of tachypnea;Pulmonary causes of tachypnea;Pulmonary causes of tachypnea;Pulmonary causes of tachypnea;Nonpulmonary causes of tachypnea;Nonpulmonary causes of tachypnea;Nonpulmonary causes of tachypnea;Clinical history and diagnosis of causes for tachypnea History Likely diagnosis Maternal history Diabetes TTN, RDS,hypoglycemia, LGA, CHD Asthma TTN Drugs Narcotic withdrawal Pregnancy induced Intrauterine growth retardation (IUGR), hypertension (PIH) polycythemia, hypoglycemia Polyhydramnios TEF Previous sibling with SPB deficiency, GBS pneumonia respiratory distress Oligohydramnios Pulmonary hypoplasia ;Clinical history and diagnosis of causes for tachypnea (cont’) History Likely diagnosis Labor and delivery Prolonged rupture of Sepsis, pneumonia membranes (PROM) Anesthesia/Analgesia Depression, apnea, cynosis Asphyxia Cerebral edema, metabolic acidosis Chorioamnionitis Sepsis C-section without labor TTN, RDS, PPHN ;Clinical history and diagnosis of causes for tachypnea (cont’) History Likely diagnosis Newborn Onset at birth TTN, RDS,