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1、新生儿窒息(英文）Thehighestmortalitythatbefallsthehumanraceinonedayoccursonthedayofbirth...….……Itissaidthatthemostimportantperiodofthelifeofahumanbeingisthetimespentinutero.Themosttryingordealahumanbeingsustainsistheordealofbirth.AsphyxiaNeonatorum:CausationandTreatmentProfessorofObstetrics,Northwester
2、nUniversityMedicalSchoolJos.B.DeLeePublishedinMedicine(Detroit)3:643-660,1897.DefinitionofPerinatalAsphyxiaaconditionintheneonatewherethereisthefollowingcombination:Aneventorconditionduringtheperinatalperiodthatislikelytoseverelyreduceoxygendeliveryandleadtoacidosis;ANDAfailureoffunctionofatlea
3、sttwoorgansconsistentwiththeeffectsofacuteasphyxia.Hypoxemia,Hypercapnia,Mixedacidosis,OrganicfailurePathophysiologyofAsphysiaRespiratoryAlteration:primaryhyperpnea,primaryapnea,secondaryapneaHypoxic-ischemicChangesofMulti-organicsystem:“divingreflex”,inter-organshunting,organfailureBiochemical
4、andmetabolicConsequences:acidosis,hyper-orhypoglycemia,hypocalcemia,hyperbilirubinemia,hyperkalemia,hyponatremiaClinicalManifestationofAsphysiaApgarScoringSystemApgarScoringSystemSign0Points1Point2PointsActivity(muscletone)absentarmsandlegsflexedactivemovementPulse(heartrate)absentbelow100bpmab
5、ove100bpmGrimace(reflexirritability)noresponsegrimacesneeze,cough,pullsawayAppearance(skincolor)blue-gray,paleallovernormal,/-extremitiesnormaloverentirebodyRespirationabsentslow,irregulargood,cryingAPGARTheSignificanceofApgarScoreApgar8~10,normal;4~7,mildasphyxia;0~3,severeasphyxiaAssignedat1,
6、5,and10min,untilscoreof7ormore1’scoreindicatetheseverityandguideforresuscitation5’scoreandlaterismorepredictiveofprognosisPrematureinfantsintendtohavelowerscoresClinicalManifestationofAsphyxiaMultiorganSystemDysfunctionRenalcompromise:oliguriaandelevatedcreatinineHypoxiccardiomyopathy(ECHOorECG
7、abnormality)Hypoxicischemicencephalopathy(HIE)Pulmonarycomplications:respiratorydistress(RDS),persistentpulmonaryhypertension(PPHN)Disseminatedintravascularcoagulation(DIC)Hepaticfailure,hyperbilirubinemiaNecrotisingenterocolitis(
