新生儿疾病neonatal_disease课件

Neonatal Problems,Defination,Neonate- 新生儿 028 days Infant-婴儿28 days1 years old.,Definition of Neonate(1): related to GA（ gestational age）,Preterm/ premature neonate:37 w 早产儿 Term neonate: 3742 w 足月儿 Post-term neonate: 42 w 过期产儿,How to identify 怎样识别,skinhead and hairearThenar（手掌）Galactophore（乳腺）Genitalia(生殖器),Difference of term and preterm skin 皮肤,Difference of term and preterm thenar 足纹,Difference of term and preterm galactophore乳腺,Difference of term and preterm ear conch耳壳,Difference of term and preterm genitalia 生殖器,Difference of term and preterm head and hair头部及毛发,Definition of Neonate(2): related to BW（birth weight）,（measure within 1st hour after birth）Tiny baby BW4000g,Definition of Neonate(3): related to both GA & BW,Small for gestational age SGA 小于胎龄儿Appropriated for gestational age AGA 适于胎龄儿Large for gestational age LGA 大于胎龄儿,Definition of Neonate(4): related to age,Early baby (perinatal baby):早期新生儿 neonate in first 7 days Late baby : 晚期新生儿 above 7 days,Definition of Neonate(5): High risk baby 高危新生儿,Is the baby who have severe conditions and need intensive care after birth, usually are those with maternal disease or abnormal delivery history. e.g, preterm baby, asphyxia （窒息）, congenital disease（先天性疾病），ect.,Some Common Diseases,Hyaline Membrane Disease (HMD)AsphyxiaHypoxic ischaemic encephalopathy(HIE) PneumoniaPulmonary HemorrhageJaundice,新生儿黄疸 (Neonatal Jaundice),Definition,The yellow skin and mucus because of too high concentration of bilirubin in the blood.,Two types of neonatal jaundices,neonatal jaundices physiological pathological 生理性黄疸 病理性黄疸,Comparison,Pathological jaundice（remember）,Onset too early 出现早Bilirubin level too high 水平高Increase too fast 发展快Disappear too late 消褪晚 D.bilirubin level too high 直接高 Return 易反复 （很重要，要记住）,Classification of jaundice,Unconjugated hyperbilirubinemia (avoid kernicterus)Conjugated hyperbilirubinemia (early diagnosis of biliary atresia),Management,Unconjugated hyperbilirubinemiaPhototherapy：wavelength 450nmAlbumin therapy Activator of enzyme：phenobarbital 5mg, nikethamide 100mg，tid for 35dBlood transfusion,Management,Conjugated hyperbilirubinemia usually need etiological treatment or surgery operation,新生儿肺炎 Neonate Pneumonia,Diagnosis,Antepartum pneumonia : early-onset within 24 h after birth, CMV, TOX, Ecoli, GBS are usual pathogensPostpartum pneumonia: same as pneumonia in children but usually severe , Virus, bacterium, fungus all can be the pathogen,Manifestation,Irregular breathingApneaTachypneaNasal flaringthree depression sign(sternal, intercostal, subcostal)Cyanosis,Diagnosis,Clinical Manifestation: irregular breathing,dyspnea,tachypnea etcRadiological Findings:some patchy shadows,empyema,atelectasis,pneumothorax can be seen,X-ray,pneumonia,atelectasis,X-ray,pneumothorax,pleural effusion,Treatment,Respiratory tract management (slap back, suction,nebulization)Oxygen therapy(avoid ROP)Antibiotics Others: balance of energy & acid- base, electrolytes, etc,What diseases we will see in clinic?,Asphyx