新生儿疾病neonatal disease.ppt

NeonatalProblems Arrangement今日安排 1 Reviewtheassociatedknowledge 25 2 Clinicalprobationinneonataldepartment 75 3 Summary 20 FamiliawiththedifferenceofpretermneonateandtermneonateGetholdofclinicalmanifestationofneonatepnemoniaGetholdofdifferenceofphysiologicalandpathologicaljaundice 目的要求ObjectiveandRequest Defination Neonate 新生儿0 28daysInfant 婴儿0 1yearsold DefinitionofNeonate 1 relatedtoGA Preterm prematureneonate 37w早产儿Termneonate 37 42w足月儿Post termneonate 42w过期产儿 Howtoidentify怎样识别 skinheadandhairearthenargalactophoregenitalia Differenceoftermandpretermskin皮肤 Differenceoftermandpretermthenar足纹 Differenceoftermandpretermgalactophore乳腺 Differenceoftermandpretermearconch耳壳 Differenceoftermandpretermgenitalia生殖器 Differenceoftermandpretermheadandhair头部及毛发 DefinitionofNeonate 2 relatedtoBW measurewithin1sthourafterbirth TinybabyBW4000g DefinitionofNeonate 3 relatedtobothGA BW SmallforgestationalageSGA小于胎龄儿AppropriatedforgestationalageAGA适于胎龄儿LargeforgestationalageLGA大于胎龄儿 DefinitionofNeonate 4 relatedtoage Earlybaby perinatalbaby 早期新生儿neonateinfirst7daysLatebaby 晚期新生儿above7days DefinitionofNeonate 5 Highriskbaby高危新生儿 Isthebabywhohavesevereconditionsandneedintensivecareafterbirth usuallyarethosewithmaternaldiseaseorabnormaldeliveryhistory e g pretermbaby asphyxia 窒息 congenitaldisease 先天性疾病 ect SomeCommonDiseases HyalineMembraneDisease HMD AsphyxiaHypoxicischaemicencephalopathy HIE PneumoniaPulmonaryHemorrhageJaundice 新生儿黄疸 NeonatalJaundice Definition Theyellowskinandmucusbecauseoftoohighconcentrationofbilirubinintheblood Twotypesofneonataljaundices neonataljaundicesphysiologicalpathological生理性黄疸病理性黄疸 case1 李X 10days female pretermneonateonsetofjaundice 3daysafterbirthtotalbilirubin 13 5mg dldirectbilirubin 1 4mg dlbirthweight 2 4kg nowweight 2 8kgfedwell sleepwellnofever nocyagnosis nodiarrhea Comparison Pathologicaljaundice remember Onsettooearly出现早Bilirubinleveltoohigh水平高Increasetoofast发展快Disappeartoolate消褪晚D bilirubinleveltoohigh直接高Return易反复 很重要 要记住 Classificationofjaundice Unconjugatedhyperbilirubinemia avoidkernicterus Conjugatedhyperbilirubinemia earlydiagnosisofbiliaryatresia Management UnconjugatedhyperbilirubinemiaPhototherapy wavelength450nmAlbumintherapyActivatorofenzyme phenobarbital5mg nikethamide100mg tidfor3 5dBloodtransfusion Management Conjugatedhyperbilirubinemiausuallyneedetiologicaltreatmentorsurgeryoperation 新生儿肺炎NeonatePneumonia Diagnosis Antepartumpneumonia early onsetwithin24hafterbirth CMV TOX Ecoli GBSareusualpathogensPostpartumpneumonia sameaspneumoniainchildrenbutusuallysevere Virus bacterium fungusallcanbethepathogen Manifestation IrregularbreathingApneaTachypneaNasalflaringthreedepressionsign sternal intercostal subcostal Cyanosis Diagnosis ClinicalManifestation irregularbreathing dyspnea tachypneaetcRadiologicalFindings somepatchyshadows empyema atelectasis pneumothoraxcanbeseen X ray pneumonia atelectasis X ray pneumothorax pleuraleffusion Treatment Respiratorytractmanagement slapback suction nebulization Oxygentherapy avoidROP AntibioticsOthers balanceofenergy acid base electrolytes etc Whatdiseaseswewillseeinclinic AsphyxiaofnewbornNeonataljaundiceNeonatalhypoxic isch