资源描述：
《新生儿缺氧缺血性脑病课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、Hypoxic-ischemicencephalopathy(HIE)新生儿缺氧缺血性脑病Children’sHospitalofChongqingMedicalUniversityProf.JialinYuOutlineNeonatalasphyxia→oxygen-poor→ischemia→braininjuredinperinatalperiodCurrentlybirthtrauma↓，O2deficiency&asphyxia↑Severeconsequence：neonataldeath
2、orchildrendisablement,oneofreasonofcerebralpalsyinchildrenhood.Commoninfulltermbb,alsoinprematurecausesmothersfetusantepartumintrapartumpostpartum20％35％35％10％hypoxiaPlacenta&umbilicalcordAnte-&intrapartumCausesofHIEalsocausesofasphyxia:Maternalfactors：i
3、llnesses，obstetricdeseases，smokingordrugaddiction,teenagepregnancies,olderthan35yearsIntrapartumfactors：umbilicalcore，malposition,placentalinsufficiency,placentalabruptionFetalfactors：congenitalanomalies,IUGR，hydropsfetalis，intrauterineinfectionInfantfa
4、ctors：apnea,HMD,MAS,PPHN,shock.EtiopathogenesisofHIECerebralbloodflow(CBF)：1.failincompensation：2stepsofredistributionDivingreflexThefirsttime---skinAdrenalglandMaintainCBFbutleadtomultiorganicdamage,SecondaryredistributionAnteriorcerebralartery,ACAmidd
5、lecerebralartery,MCAPosteriorcerebralartery,PCABranchofACABranchofMCABranchofPCAterminfant：皮层矢状旁区受损preterminfant：脑室周围的白质区受损Consequenceofsecondaryredistribution脑室旁白质软化periventricularleukomalacia,PVLSuddenly&completelyasphyxia2.Non-compensation：ganglion-b
6、rainstemdamageCerebralbloodflow(CBF)：3.autoregulation↓→Pressure-passivecerebralcirculation(PPCC)Cerebralischemia,HIEBrainedemacerebralhemorrhageBPCBFPPCCCerebralbloodflow(CBF)：Changeofbrainmetabolism:1.oxygenfreeradicals→ruptureofcellmembranedestroyBBB(
7、1)overproduction：cytochrome-oxydase↓；reperfusion：xanthineoxidase↑hypoxanthine----------------→urea+oxyradicals(2)removenotenough：超氧化物歧化酶（SOD）↓Changeofbrainmetabolism:2.imbalanceofNa&Ca：anaerobicglycolysis→lacticacid↑,ATP↓→pumpoutoforder→Ca++inflow→chaos
8、ofsignal→Na++inflow→intra-cellularedema3.excitableneurotransmitter:glutamicacid；β-opioidpeptideneuropatholgy：脑细胞水肿(edema)脑细胞坏死(necrosisofbraincells)脑细胞凋亡(apoptosis）commonlyoccurafter6-24h,keepinseveraldaystowkspromptlyinterventio
