英新生儿窒息与新法复苏课件.ppt

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1、NeonatalAsphyxiaanditsNewConceptonResuscitationChongminXuDep.NewnatesUnionHospitalNewWordspregnantwomaninvalidApgarscoreumbilicalcordprimaryapneaasynersisHIE(hypoxic-ischemicencephalopathy)ICH(intracranialhemorrhage)MOD(multipleorgansfunctiondamage)hypercapniahypoxemiaNeonatala

2、sphyxiaisakindofgasexchangedisorder,thatcouldcausehypoxemia,hypercapniaandmetabolismacidosis,whichisaccountedonthatnewbornhasnoautorespirationoronlyhasirregular,intermittentandfeeblerespirationatbirth,orpresentrespiratorydepressionafterbirth.It’sincidenceisabout5%occupiedthevia

3、blebirth,andcancause20%deathintoltalnewnataldeath.Thenatureofasphyxiaitselfishypoxia.UsuallyweadoptApgarscoretojudgethedegreeofasphyxiation.AsphyxiacouldcausenotonlyHIE,butalsoMOD,andistheoneoftheimportantcausesofdeath,dysnoesiaandinvalid(cerebralpalsy)innewbornsallovertheworld

4、.Neonatalmortalityisabout19.0‰(2005)inourcountry.Thefirstthreedeathcausesareprematurebirth&lowbirthweight,asphyxiaandpneumonia.Thereare1millionnewborndeathcausedbyneonatalasphyxia(total4millionyearly-2005.WHO),and>1millionneonatessufferfromdysnoesia,cerebralpalsyandotherdeformi

5、tycausedbyittoo.DeliveryfactorsPlacentafactorFetalfactorumbilicalcordfactorPregnantwomanAsphyxialetiopatho-genisistooolderoryoungRespiratorydiseasecardiacdiseasesevereanaemiaSmoking&druggestationalhypertensionPregnantwomanfactorpolycyesisdiabetesplacentapraeviaplacentalabruptio

6、ninfarctusageingPlacentafactorshortcordknotofumbilicalcordumbilicalhangdownumbilicalcordcircleneckUmbilicalfactor胎儿因素prematurelargefordateinfantintrauterineinfectionrespiratorytractobstructioncongenitalcardiopathycongenitalabnormalityfoetusfactorsuckingfetalheadforcepsaiddelive

7、rbreechpresentationunsuitablyusedrugsinlaborlaborextension&precipitatelaborcephalopelvicdisproportiondeliverfactorPathophysiologySwitchofrespiration&circulationfromfetustonewbornareblockedBreathalterbiochemistry&metabolismalterinbloodfetalpulmonaryfluidisremovedfromlungs↓surfac

8、eactivesubstance(SAS)secretes↓functionalresidualcapaci