新生儿疾病neonatal disease.ppt

NeonatalProblems 2020 4 9 Arrangement今日安排 1 Reviewtheassociatedknowledge 25 2 Clinicalprobationinneonataldepartment 75 3 Summary 20 2020 4 9 FamiliawiththedifferenceofpretermneonateandtermneonateGetholdofclinicalmanifestationofneonatepnemoniaGetholdofdifferenceofphysiologicalandpathologicaljaundice 目的要求ObjectiveandRequest 2020 4 9 Defination Neonate 新生儿0 28daysInfant 婴儿0 1yearsold 2020 4 9 DefinitionofNeonate 1 relatedtoGA Preterm prematureneonate 37w早产儿Termneonate 37 42w足月儿Post termneonate 42w过期产儿 2020 4 9 Howtoidentify怎样识别 skinheadandhairearthenargalactophoregenitalia 2020 4 9 Differenceoftermandpretermskin皮肤 2020 4 9 Differenceoftermandpretermthenar足纹 2020 4 9 Differenceoftermandpretermgalactophore乳腺 2020 4 9 Differenceoftermandpretermearconch耳壳 2020 4 9 Differenceoftermandpretermgenitalia生殖器 2020 4 9 Differenceoftermandpretermheadandhair头部及毛发 2020 4 9 DefinitionofNeonate 2 relatedtoBW measurewithin1sthourafterbirth TinybabyBW4000g 2020 4 9 DefinitionofNeonate 3 relatedtobothGA BW SmallforgestationalageSGA小于胎龄儿AppropriatedforgestationalageAGA适于胎龄儿LargeforgestationalageLGA大于胎龄儿 2020 4 9 DefinitionofNeonate 4 relatedtoage Earlybaby perinatalbaby 早期新生儿neonateinfirst7daysLatebaby 晚期新生儿above7days 2020 4 9 DefinitionofNeonate 5 Highriskbaby高危新生儿 Isthebabywhohavesevereconditionsandneedintensivecareafterbirth usuallyarethosewithmaternaldiseaseorabnormaldeliveryhistory e g pretermbaby asphyxia 窒息 congenitaldisease 先天性疾病 ect 2020 4 9 SomeCommonDiseases HyalineMembraneDisease HMD AsphyxiaHypoxicischaemicencephalopathy HIE PneumoniaPulmonaryHemorrhageJaundice 2020 4 9 新生儿黄疸 NeonatalJaundice 2020 4 9 Definition Theyellowskinandmucusbecauseoftoohighconcentrationofbilirubinintheblood 2020 4 9 Twotypesofneonataljaundices neonataljaundicesphysiologicalpathological生理性黄疸病理性黄疸 2020 4 9 case1 李X 10days female pretermneonateonsetofjaundice 3daysafterbirthtotalbilirubin 13 5mg dldirectbilirubin 1 4mg dlbirthweight 2 4kg nowweight 2 8kgfedwell sleepwellnofever nocyagnosis nodiarrhea 2020 4 9 Comparison 2020 4 9 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 2020 4 9 Classificationofjaundice Unconjugatedhyperbilirubinemia avoidkernicterus Conjugatedhyperbilirubinemia earlydiagnosisofbiliaryatresia 2020 4 9 Management UnconjugatedhyperbilirubinemiaPhototherapy wavelength450nmAlbumintherapyActivatorofenzyme phenobarbital5mg nikethamide100mg tidfor3 5dBloodtransfusion 2020 4 9 2020 4 9 2020 4 9 Management Conjugatedhyperbilirubinemiausuallyneedetiologicaltreatmentorsurgeryoperation 2020 4 9 新生儿肺炎NeonatePneumonia 2020 4 9 Diagnosis Antepartumpneumonia early onsetwithin24hafterbirth CMV TOX Ecoli GBSareusualpathogensPostpartumpneumonia sameaspneumoniainchildrenbutusuallysevere Virus bacterium fungusallcanbethepathogen 2020 4 9 Manifestation IrregularbreathingApneaTachypneaNasalflaringthreedepressionsign sternal intercostal subcostal Cyanosis 2020 4 9 Diagnosis ClinicalManifestation irregularbreathing dyspnea tachypneaetcRadiologicalFindings somepatchyshadows empyema atelectasis pneumothoraxcanbeseen 2020 4 9 X ray pneumonia atelectasis 2020 4 9 X ray pneumothorax pleuraleffusion 2020 4 9 Treatment Respiratorytractmanagement slapback suction nebulization Oxygentherapy avoidROP AntibioticsOthers balanceofenergy acid base electrolytes etc 2020 4 9 Whatdiseaseswewillseeinclinic AsphyxiaofnewbornNeonataljaundiceNeonatalhypoxic ischaemicencep