英-新生儿窒息与新法复苏是5.ppt

;Neonatal Asphyxia and its New Concept on Resuscitation ;New Words pregnant woman invalid Apgar score umbilical cord primary apnea asynersis HIE ( hypoxic-ischemic encephalopathy) ICH (intracranial hemorrhage) MOD (multiple organs function damage) hypercapnia hypoxemia; Neonatal asphyxia is a kind of gas exchange disorder, that could cause hypoxemia, hypercapnia and metabolism acidosis, which is accounted on that newborn has no auto respiration or only has irregular, intermittent and feeble respiration at birth, or present respiratory depression after birth. It’s incidence is about 5% occupied the viable birth,and can cause 20% death in toltal newnatal death. The nature of asphyxia itself is hypoxia. Usually we adopt Apgar score to judge the degree of asphyxiation. ; Asphyxia could cause not only HIE, but also MOD, and is the one of the important causes of death, dysnoesia and invalid (cerebral palsy) in newborns all over the world .Neonatal mortality is about 19.0‰ (2005) in our country. The first three death causes are premature birth low birth weight, asphyxia and pneumonia. There are 1 million newborn death caused by neonatal asphyxia (total 4 million yearly-2005. WHO), and 1 million neonates suffer from dysnoesia, cerebral palsy and other deformity caused by it too. ;Delivery factors; ?????????????????????????????????????????????? ;placenta praevia;short cord;胎儿因素;sucking fetal head ;Pathophysiology; ;Blocked switch of respiration circulation from fetus to newborn ;Hypoxia-ischemia alter in difference organs as asphyxia; Breath alter 1．Primary apnea When hypoxia, the baby may breath deeply and quickly at first l-2 mins, if no management in time, it may occur breath inhibition and reflective heart rate decreasing in a short time. ． 2．Secondary apnea If the hypoxia persistence, the baby may occur gasping respiration, heart rate continue step down, the BP begin