新生儿心衰68例研究及治疗体会.doc

新生儿心衰68例研究及治疗体会摘 要 目的：新生儿心力衰竭抢救不及时死亡率很高，分析原因可以指导临床尽早明确诊断及时处理，从而降低死亡率。方法：收治心力衰竭患儿68例。先天性心脏病合并肺炎心衰占主27/68(40%)；单纯性心脏病20例(29%)，早产儿肺透明膜病3例，重围产期窒息并发心衰5例，肺炎心衰6例，败血症3例，心内膜弹力纤维增生症2例，心肌炎2例。患儿经镇静、鼻伺喂养、限制液量、利尿、抗炎、强心、支持治疗及对症等治疗。结果痊愈23例(33.8%)，好转29例(42.6%)，死亡8例(11.7%)，自动出院8例(11.9%)。结论：新生儿心力衰竭如不及时抢救死亡率很高，要降低死亡率需做到早期诊断及时治疗。 关键词 新生儿心力衰竭 分析 治疗 doi:10.3969/j.issn.1007-614x.2012.17.138 Abstract Aim:The critical condition of heart failure for a neonate can be caused by many reasons,if can’’t be rescued immediately,the death rate will be high.Therefore,early diagnosis and quick cure can reduce the death rate.Method:make a analysis of 68 neonates among 2005～2010 in this hospital,and it shows that complicate pneumonia congestive heart failure accounts 27/68(40%),simple heart disease 20 cases,accounts 29% and neonatal respiratory distress syndrome(NRDS)3 cases,The siege of complicated prenatal asphyxia with heart failure 5 cases,the heart failure with pneumonia 6 cases,septicemia 3 cases,the proliferation of intrahepatic elastic fibers 2 cases,myocardium 2cases.Through the comprehensive cure,in the way of limiting liquid amount,tranquilizing,dieresis and anti-inflammatory as well as cardiac action and other supporting treating methods.As a result ,23 cases are recovered(33.8%),29 cases getting better(42.6%),8 cases are failed(11.7%)and 8 cases leaving hospital automatically(11.9%).Conclusion:heart failure for a neonate is critical featuring quick development and high death rate which requires early diagnosis and immediate cure,thus the death rate can be lower. Key words neonatal heart failure analyse cure 新生儿心力衰竭病因及临床表现于年长儿不同，发病急，进展快，治疗不及时死亡率很高，因此早期诊断治疗显得尤为重要。 资料与方法 2005～2010年收治新生儿心力衰竭患儿68例，参考全国新生儿学术会议所定心衰标准，显示先天性心脏病合并肺炎心衰占主要比例27/68(40%)，先天性心脏病中以室间隔缺损、房间隔缺损、动脉导管未阔闭，单一或合并两种以上为多见，如大血管错位，主动脉，狭窄、左心发育不良、完全性肺静脉异位引流及后椎性畸形；单纯性心脏病20例(29%)，其中早产儿动脉等管未闭11例，复杂畸形9例，肺炎心衰6例(8.8%)，败血症3例(4.4%)。早产儿肺透明膜病3例(4.4%)，重症围产期窒息并发心衰5例(7.3%)。心内膜弹力纤维增生症2例(3%)，心肌炎2例(3%)。足月儿60例。旱产儿8例：其中男37例，女31例，＜1周26例，7～