新生儿窒息

2016-10-17 10:01 阅读: 编辑:sunyoung 来源:家有宝宝
标签: 新生儿窒息
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内容简介:新生儿窒息是出生后最常见的紧急情况,必须积极抢救和正确处理,以降低新生儿死亡率及预防远期后遗症。
       新生儿窒息是指由于产前、产时或产后的各种病因,使胎儿缺氧而发生宫内窘迫或娩出过程中发生呼吸、循环障碍,导致生后1分钟内无自主呼吸或未能建立规律呼吸,以低氧血症、高碳酸血症和酸中毒为主要病理生理改变的疾病。

新生儿窒息
       一、病因

       
1.出生前的原因
  

       (1)母体疾病如妊娠期高血压疾病、先兆子痫、子痫、急性失血、严重贫血、心脏病、急性传染病、肺结核等。
  

       (2)子宫因素如子宫过度膨胀、痉挛和出血,影响胎盘血液循环。
  

       (3)胎盘因素如胎盘功能不全、前置胎盘、胎盘早剥等。
  

       (4)脐带因素如脐带扭转、打结、绕颈、脱垂等。
  

       2.难产

       如骨盆狭窄、头盆不称、胎位异常、羊膜早破、助产术不顺利或处理不当以及应用麻醉、镇痛、催产药物不妥等。
  

       3.胎儿因素

       如新生儿呼吸道阻塞、颅内出血、肺发育不成熟以及严重的中枢神经系、心血管系畸形和膈疝等。

       二、临床表现

       1.胎儿娩出后,面部与全身皮肤青紫色或皮肤苍白,口唇暗紫。

       2.呼吸浅表,不规律或无呼吸或仅有喘息样微弱呼吸。

       3.心跳规则,心率80~120次/分钟或心跳不规则,心率〈80次/分钟,且弱。

       4.对外界刺激有反应,肌肉张力好或对外界刺激无反应,肌肉张力松弛。

       5.喉反射存在或消失。

       三、预防

       
1.围产保健

       加强围产保健,及时处理高危妊娠。
  

       2.胎儿监护

       加强胎儿监护,避免和及时纠正宫内缺氧。对宫内缺氧胎儿,可通过羊膜镜了解胎粪污染羊水的程度,或在胎头露出宫口时取胎儿头皮血进行血气分析,以估计宫内缺氧程度PG和SP-A在接近出生前偏低,或L/S、PG、SP-A均很低,发生RDS的危险性非常高须积极采取措施。
  

       3.避免难产

       密切监测临产孕妇,避免难产。
  

       4.熟练掌握复苏技术

       培训接产人员熟练掌握复苏技术。
  

       5.配备复苏设备

       医院产房内需配备复苏设备,高危妊娠分娩时必须有掌握复苏技术的人员在场。
标签: 新生儿窒息
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