早产儿呼吸窘迫综合征欧洲共识中英对照.pptxVIP

早产儿呼吸窘迫综合征欧洲共识中英对照第1页/共24页 Prenatal Care产前治疗Mothers at high risk of preterm birth should be transferred to perinatal centres with experience in management of RDS(C).有早产高危因素的母亲应被转运至对处理新生儿呼吸窘迫综合症有丰富经验的医疗中心。Clinicians should offer a single course of antenatal steroids to all women at risk of preterm delivery from about 23weeks up to 35 completed weeks’ gestation (A).对于孕23周至35周有早产高危因素的母亲，医生均应使用一疗程产前激素。Antibiotics should be given to mothers with preterm pre-labour rupture of the membranes as this reduces the risk of preterm delivery (A).对于有早产高危因素合并胎膜早破的孕妇，抗生素的使用可减少早产的发生。第2页/共24页 Clinicians should consider short-term use of tocolytic drugs to allow completion of a course of antenatal steroids and/or in utero transfer to a perinatal centre (A).医生应考虑短期使用抗分娩药物，使产前激素疗程可完成/能及时转运至医疗中心。A second course of antenatal steroids should be considered if the risk from RDS is felt to outweigh the uncertainty about possible long-term adverse effects (D). One example where benefit might outweigh the risk is multiple pregnancy (C).若考虑发生新生儿呼吸窘迫综合征的危险大于使用激素产生长期副作用的不确定性，应考虑使用第二疗程的产前激素。其中一个利大于弊的例子是多胎妊娠。第3页/共24页 Delivery Room StabilisationIf possible, delay clamping of the umbilical cord for at least 30-45 s with the baby held below the mother to promote placento-fetal transfusion (A).如果可能，延迟钳夹脐带30-45秒，且使婴儿位置低于母亲，有利于母-婴输血。Oxygen for resuscitation should be controlled by using an air-oxygen blender. The lowest concentration of oxygen possible should be used during stabilisation, provided there is an adequate heart rate response. A concentration of 30% oxygen is appropriate to start stabilisation and adjustments up or down should be guided by applying pulse oximetry from birth to give information on heart rate (B). Normal saturations during transition immediately after birth in very preterm infants may be between 40 and 60%, reaching between 50 and 80% at 5 min of age and should be 85% by 10 min of age. Exposure to hyperoxia should be avoided during stabilisation (B).复苏时氧气浓度需用空气-氧气混合器控制。需要使用最低的氧浓