新生儿氧气疗法

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1、新生儿氧气疗法1,?=?J2(1.?e?,?F?e?p?,?e?714000;2.?P?t?:?/?,?710014)=?=?b?/?v;?t?;?,?=?=?e?7?R459.6=?b?4?1B=?a?167125098(2007)17223882031=?t?:?Z?j?0?,?t?9?p?(?S?t?y?=,2=?t?,?2.1=?F?4?=?:?t?(SaO2)<80%?=,?u?f?y?,?;?t?7?(PaO2)?8kPa(60mmHg)?,?+?y?E?=5g/dl,?R?5?I=,?a?y?d?y?;?N?u?=1?N?:?;?=1?V?=1?:?/?Z?N?;?=1?R

2、?;?u?f?y;?=1?R?;?(?y?B?=1?=1?9?=,2.2=?y?:?4?4=?j?N?:?,PaO2<50mmHg?a?t?(TcSo2)<85%?.,?4?4?r?1PaO250mmHg?80mmHg?aTcSo290%?95%=,3=?t?t?p?t?.?,?j?t?5?;?N?V1=,?:?p?N?V?t?z?,?f?r?j?/2=,?9?P?/?v?R?4?:?R?P?:?,100%?t?r?j?,Saugstad=1Ramji?Z?/?v?R?+?j?t?r?;?i?3=,Ecoff=1Debrar?p?:?t?5?t?j?(1508g?1250g)?/?

3、v?R?e,?.?<?5?.=,?,?M?;?0?,?t?=,3.1=?V?=?,?j?p?t=,?z?.?O?V?I?,?V?t?=?p:?N?t?=21+4?t?W?(L/min)=,?D?t?W?0.5L/min?1L/min,?p?t?r?=?N?t?,?R?K?7?a=,3.1.1=?V?K?=?7?+?V?1?V?=,?t?W?v1L/min?2L/min=1?/?v0.3L/min?0.5L/min,?N?t?(FiO2)?p0.25?0.3=,3.1.2=?V?=?7?V?e,?FiO2>0.3=,?&?p?t?t,?9?v?;?R?6?=,3.1.3=?M

4、?V?=?7?0.4cm?,?j?f?2cm?p?,?7?E?V?,?p?V?,?j?2?7?V?),?t?W?P?j2L/min?4L/min=,?=1?8?,?z?=,3.2=?V?=?,?j?e=1?p?t=,?7?t?9?,?V?I?V?e,?,?t,?V?,FiO2?0.8?0.9=,3.3=?=?,?j?p?t=,?j?9?5?,?i?=,?V0.5cm?1cm?p?=,?t?W?j?2L/min?5L/min,?&?.?v?=,3.4=?F?t?=?v?F?I?j?9?5?;?p?,?7?:?+?:?1?,?t?W?DL?6L=,FO?p5,?jL,FO?6=,?2?t?

5、W?:?I?,?M?FO,?t?,?,?v?8?,?R?,?&?O?t?t,?i?,?v?9?R?j=,3.5=?t?:?6=?,?O?t?t,?;?jCO2?,?B?j=,3.6=?t=?7?t?I?,?F?N?j4L/min?6L/min?t?W?,FiO2?D?j40%?,?,?j?9?v=,3.7=?1?:?t(CPAP)=?:?,?L?5?,?B?7?W,?u?t?y?=,?,?PaO2<8.0kPa(60mmHg)=1SaO2<90%=1PaCO2<9.3kPa(70mm2Hg),?V?N?P?;?NRDS?v?D?j4cm?6cmH2O(0.4kPa?0

6、.6kPa),?j?10cm?12cmH2O,?j?P?t?=1?N?p?=,?3?p?I?t?9?0?,?V?,?7?N?F?1?N?V?,?F?pCPAP?h=,?t?W?10L/min,FiO2?=0.8?1.04=,?V?j?9?5?(HMD)=1?N?0?=1?F?=1?y=1?v?R?N?=1?4?r?5?N?p?=,?p?r?,?N?t,?&?j?:?0?9?2?FiO2,?EME?VCPAP?=,3.8=?N?p?t=?,?j?u?N?,?N?v=,?4?:?jFiO2?p0.6?,PaO2<50mmHg?a?y?t?(TcSo2)<85%(?f?z?i?t

7、?9?a);PaCO2>60mmHg?70mmHg?FpH?h<7.25;?u?a?N?z?N?,?4?e?.=,?pRDS?.?,?I?4?5=,?a?:?RDS?v?j?p?P?:,?j?B?W?P?:,?PaCO2?1?j?F?,?PaO2?1?j?F?=,?N?p?t?j?a?V?:?a?:?4?t,?t?M?9?2?(?0.21?1.00)6=,Vemtom,Asensim?:?p?t?/?v?R?<?,?R?j?:?=,?&?B?3?p?j?t?,?j20.93%?:?t?t;?;?t?p?;=,3.9=?a?t?0?jd:?=?a?a?,?y?t?;?S

8、?,?P?a?t?0?j,?ICO2,?C?5?;?a?;?=,?j?4?:?y;?>2000g,?>35?;?z?i?t?,?N;?p?P?:?<10d;?r?7?;?d:?;?y?t?7?>80kPa(600mmHg),?16h?8h=,?3?j?4,?M?j?,?>,?=,3.10=?P?:=?r?:?:?=1?r?:?r?N?P?:?=,?v?;?j?(=,?7?p?P?:(TLV),?j?/?a?(F)?N?e?:?,?,?R?j=,?7?P?:(LV),?j?3?F?:?,?j?N?N?p?:?=,?:?r?j?8832?j?V?w?2007?6?0?

9、D14?D17?/(?)=?JPMT,June.2007,Vol.14,No.17(IssuedEveryTenDays)?84/min/mini20.410/mini20.i2:PCsP20ml/kg0ml/kgPCs,PLV?:?j,?P?:?R?=,3.11=?t?3.11.1=?/?v?p?y?p?t?t?B?o=?t?y?t?f?y?t?7?,?B?y?f?t?B?e?t?I?,?y?t?;?z?u?,?/?M?/?v?(?9?=1?p?t?1=,?M?;?t?T,?B?t?,?t?;?p?/?B,?/?6?,?K?e?,?J?=,?t?B?F?,?=,?M?p?t=1?C?i?,?

10、C?+?N?Z?=,?t?V?p?t?/?+?:?,?V?+?F?,?=?=,?p0.05MPa?0.07MPa,?l?N?t?40min?60min,1?l/d,10?l?p1?E?,?j2?E?3?E?=,3.11.2=?/?v?N?0?(neonatalrespiratorydistresssyndrome,NRDS)=?t?/?N?d?6?p?u?p?t?+?p?t?S?p?(?7?a;?t?y?p?t?M?y?C?i,?y?O?9?t?,?O?B,?;?i?)?R,?V?F?/?9?5?6=,?p0.03MPa?0.15MPa,?l?N?t?40min?60min,1?l/d,?0?

11、p?,?D1?E?=,?9?J?t?,?j?/?512h?;?i?j?+?/?vdm?dH?,?t?f?1?j90%?)=,?v?j,?f?r<32?v=,3.11.3=?N?0?=?t?/?v?p?t,?g?.?r?:?,?,?p?p?,?p?/?d?j=,?7?j0.15MPa?0.20MPa,?l?N?t?60min,1?l/d,?p?t?,?C?=,?a,?/?v?=1?/?v?F?o?j?t?=,4=?t?9?4.1=?i=1?=?B?:?p?=,?i?D?;?32l2?34l2,?a?j?F=,4.2=?p?=?t?4?,?f?=1?N?1=1?N?=1?1,?0?y?t?y

12、?t?,?j?1?/?y?:?5,?2?=,?o?VLBWI?t?1?y?t?a?t?,?N?t?5?M?,?,?N?K?t,?,?N?,?10?l/min?),?5?;?z=,?,?5?t?R?,?y?:?7?,?5?=,?;?V?a?t?t,?Z?/?N?C,?=,4.3=?t?4?4=?t?5?n?,?p?t?CO2?M?,?,?N?n,?N?:30min?5,PaO2>60mmHg=1PaCO2<50mmHg,?t?=,?t?z?B?t?W?,?n,?6?6?=,4.4=?9?=1?L?Z=,5=?t?j?(?75.1=?N?C=?/?p?t?F?u?CO2?.?t?=,?

13、r?+?t?t?N?e?p?j,?t?,?j?N?w,?j?p?N=,5=?t?e?=?t?e?/?t?7?t?,?N?:?t?7?,?:?;?y?t?7?y?,?y?5?t?7?t,?t?u?/,?P?t?e?(?V?r?t?+?/?F?)=,?t?e?:?=1?B?h?=,5.2.1=?t?e?=?v?S?r?:?R?(BPD),?r?+?N?t(FiO2>0.4),?r?:?)?8=,?/?u?t?,?=?6?9=,?&?j?:?pBPD?6?5?E?6?;?/?/?;?;?1?I;?y?;?F?4=,5.2.2=?B?t?e?=?N?2?E?3?E?t?:?)?t,?j?

14、S?B?t?e?(6?E?t?:?t?7?=14?E?t?:?t?W?7?),?v?V?=1?6=1?Z?,?u?.?9?=1?=,?t?v?,?p?7?B?t?e?5?p?t?S?p?t?t?B?=,?.?v?z?6?5?9?,?6?v?r?.?;?5?.?%?z?9?5?6=,?t?e?.?C?N?t;?&?p?t?t?B?.?%?p?N?t=,5.2.3=?t?h?j=?v?(ROP)?r?t?e?=,?v?,?h?y?5?U?j?/?5?6=,?p?/?,?t?:?j,?&?r?j?t?:,?=1?(FiO2>0.4)?y?t?,?E?6?h?y?R?B?<

15、?/?N,?r?j?/?=1?=1?d?O?P?y,?6,?C?i=1?,?+=,?l?j?/?54?6?a?32?,?r?dm?dH,?%?dm?dH?7?d?6?N?K?+?510=,?;ROP?7?y?;?/?<1500g?v?,?r?V?tROP,?+?h?4?R?,?V?T?0?0?d?6?+?511ROP?/?v?r?/?<750g?/?v=,?t?,?&?v?o?/?v(?<1500g),?;?/?1?y?t?,?s?%?R?V?d?/?j?t=,?j?a,?j?t?R?40%12,?t?2?(95%?98%)?t?v?/?5?I?(,?:?7?o13=

16、,?M?/?7?7?F?:?,?v?9?t?R?&?,?P?;?i=,?V?u?h?y?t?t?7?a?t?,?s?%?P?j?R?R?e?6?B?i?u?,?e?V?9?E?0?e?+?6?Edm?dH?=,?L?r?z?u?h?j?t?4?,?j?j?t?,?t?D?R?>0.4,?R?E?,?a?/?j?/?dA=1?/?dE,?;?L?j14,?u?h?=?C?y?ROP?/?,?=1?b=,?R?;?p32?36?5?1?K?t?h?r?R?14=,?t?P?S?E?6?v?a,?&?4?=,5.3=?+?b?t?R?d=?r?+?N?t?5,?y?N?b?/?

17、a,?6?6?5?i?R?d15=,?a?U?RDS?v?N?NO?0?t?t?/?=,?2?b:1=?PanitchHB.Respiratorysyncytialvirusbronchiolitis;supportivecareandtherapiesdesignedtoovercomeairwayobstructionJ.Pe2diatrInfectDisj,2003,22(2suppl):83287,87288.2=?Ola,DidikSaugstad,siddarthRamji,etal.OxygenforNewbornRe2?,6,8()83=?Kff,DLMRRVx2yRDyRf?

18、9832?j?V?w?2007?6?0?D14?D17?/(?)=?JPMT,June.2007,Vol.14,No.17(IssuedEveryTenDays)?8.2suscitation:HowmuchisenoughPediatricsJ.Evanston200112:79.arenEcorebracCann.oomAiressuscitationersusogenesuscitationintheeliveroomJ.Joumaloperinatal&NeonatalNursing.Frederick:Oct2Dec,2005,19(4):379.4=?PieperCH,Sm

19、ithJ.IsCPAPofvalueinextremepretermswithnoaccesstoneonatalintensivecareJ.JTropPediatr,2003,49(3):1482152.5=?Kumrp,KiranPS.Changingtrendsinthemanagementofrespiratorydistresssyndrome(RDS)J.IndianJPediatr,2004,71(1):49254.6=?VentoM,AsensiM.oxidativestressinasphyxiatedterminfantsre2suscitatedwith100%oxyg

20、enJ.JPediatr,2003,142(3):2212222.7=?F?E,?+?.?t?j?v?jM.?D1?z.?O?:?B?V?z?I,2003:57.8=?VrijlandtEJ,DuivermanEJ.chroniclungdiseaseoftheneonate:pathophysiologyandtreatmentafterthefirstweaksoflifeJ.NedTijdsckrGeneeskd,2003,6:147(49):241222417.9=?Al2AmroSA,Al2KharfiTM.Retinopathyofprematurityatauniver2sity

21、HospitalinRiyadh,SaudiArabiaJ.SaudiMedJ,2003,24(7):7202724.10=?BancalariE,ClaureN.Bronchopulmonarydysplasia;changesinpathogenesis,epidemiologyanddefinitionJ.SeminNeonatol,2003,8(1):63271.11=?OConnorMT,VohrBR.Isretinopathyofprematurityincreasinga2monginfantslessthan1250gbirthweightJ.JPerinatol,2003,2

22、3(8):6732678.12=?AskieLM,Henderson2smartDJ.oxygen2saturationtargetsandout2comesinextremetypreterminfantsJ.NEnglJMed,2003,349(10):9592967.13=?SinhaSK,JinW.ThecontroversiessurroundingoxygentherapyinneonatalintensivecareunitsJ.CurrOpinPediatr,2003,15(2):1612165.14=?GleissnerMW,SpantzelT.Riskfactorsofre

23、tinopathyofprematuri2tyininfants32to36weeksgestationalageJ.ZGeburtshilfeNeonatol,2003,207(1):24228.15=?SchreiberMD,Gin2MestanK.Inhalednitricoxideinprematurein2fantswishtherespiratorydistresssyndromeJ.NEnglJMed,2003,349(22):209922107.(?C?v?/:2007203214)HCG?F?9?Z?=?(?I?252?V?,?O?071000)?=?HCG?t?,?d?5?

24、o?,?e?5?/?HCG?a?,?N?v?z?z?7?;HCG?7?,?N?S?L?A?L?(?L?)?/?a?4?4?,?N?t;HCG?j?v?9?F?5,?A?t?.?HCG?v?e?4?9?Z=,?b?7?d;HCG;?A?t?e?7?R446.62=?b?4?1B=?a?167125098(2007)1722390202=?=?HCG?p?HumanChorioninGonadotropin?i?s?,?r?+?w?/?;?t?d,?/?V?t?5?/?6?d(LH)?h=,?y?:?,HCG?,?N?v=1HCG?7?,?N?S?L?(?L?)?HCG?j?A?t?e?;?y?h

25、,?+HCG?j?F?e?9?Z?=,1=?HCG?j?t?t?e?9?Z1.1=?1?t?,?d(PEP)=?y?,?d?t?r?P,?1?tPFP?S?.?,PEP?r?4?t?r?5?=1?.?F?=1?y=1?u?.?/?,?PEP?l?P?r1=,Mock?Z?7PEP?r?5?yHCG?V?a?7?p?=1?o?E?/,?/?4?r?50h?48h,?/HCG?h?r?HCG?F?,?/?r?4?r?53d?7d,?r?d?V,?r?5?/2?2HCG?F?pPEP?2=,?a?,?o?r?d?,?C?j?/?;?/,?&?;?5?I?p?f,?)?r?j?G?N?d?;?

26、5?I?R?,?y?/?/?R?7?t?HCG,HCG?p?a?4?4?3,?&?;?a?.?j?y?51?2?=?N?.?F?,?G?F?t?,?,?5?7?,?=,=?L?t?=?,?a?:?/?7?t?7?t?d?L?A?F?L?/?a?4?4?,?N=,?d?/?+G?,?N?7?S?L?pTS?C,?C?5?6?;?,?L?p?6?.?N?,?u?d?6?.?j?D?z?,Kimura?4?L?1?d?e?/?L?,HCG?TSH?C,?F?)?L?L?V?/?a?4?4?,?N4,5=,HCG?TSH?C?z?/?,?L?F?)?r?s?,?=,2=?HCG?v?9?Z2.

27、1=?v?3(IUGR)=?IUGR?r?d?/?N?,?yHCG?G?>2.5MOM?5?v?/?3?5?I?,?5?d?/?y?o?w?t?B,?t?/?HCG?,?O?1?TUGR?/=,?:?,?e?/?yHCG?F?0?6?r?IUGR?6=,20?a?90?+?:?HCG?F?G?v?IUGR?/?I?,?p?yHCG?F?p?IUGR?/?a?4?4,?e?/?yHCG?F?,?r?R?d?y?7=,2.2=?v?(Fetaldistress)=?r?4?v?j?p?t?e?/?0?,?/?p2.7%?38.5%=,?S?v?;?y?t?f?R?=1?y?t?v?d?,?N,?e?E?,?N?v?=,?:?5?v?yHCG?j?/?5?I?N?d?,?p?d?e?/?yG?G?r?/?,?/?r?F?=1?=1?p?y?Z?,?5?v?P?/?yG?h?8,=,?0932?j?V?w?2007?6?0?D14?D17?/(?)=?JPMT,June.2007,Vol.14,No.17(IssuedEveryTenDays)?81.2HCHHCHC9