论文部分内容阅读
9例新生儿术后短期内呼衰死亡原因:①低温。新生儿低温使静麻药与肌松药的作用延长,术后呼吸恢复不全,产生低氧血症。术后复温过程中代谢率与氧耗增加,加重了组织乏氧程度,导致代谢性酸中毒,影响新生儿体内酶的正常代谢,减少肺表面活性物质的产生,低氧血症进一步加重,形成恶性循环,呼衰致死。②静麻药用量过大。6例低日龄新生儿使用或复合使用硫喷妥钠,其用量有的远远超过单独使用的一般常用量。如出生仅1 1/2h内的早产儿,用量12.5mg/kg,手术2h,用芬太尼5.7μg/kg;日龄4天,安定用量为正常量的4～5倍。静麻药用量过大必然加重和延长术后的呼吸抑制;③术后保留气管导管送回病房,过早的停止有效的呼吸管理,而致通气量不足。因此术后在吸氧的条件下,维持足够的通气量,对避免新生儿呼衰死亡具有重要意义。
9 cases of neonatal respiratory failure in short-term causes of death: ① low temperature. Neonatal hypothermia so that the role of static anesthesia and muscle relaxants, postoperative respiratory insufficiency, resulting in hypoxemia. Postoperative rewarming process metabolic rate and oxygen consumption increased, increasing the degree of tissue hypoxia, resulting in metabolic acidosis, affecting the normal metabolism of neonatal body enzymes, reduce pulmonary surfactant production, hypoxemia further aggravate, The formation of a vicious cycle, call failure fatal. ② static anesthetic dosage is too large. 6 cases of low-age neonatal use or combination of thiopental, the amount of some far more than the commonly used amount alone. If only 1 1 / 2h of birth within preterm children, the amount of 12.5mg / kg, surgery 2h, fentanyl 5.7μg / kg; day 4 days, the amount of stability for the normal amount of 4 to 5 times. Static drug dosage is bound to aggravate and prolonged postoperative respiratory depression; ③ postoperative tracheal catheter to return to the ward, premature termination of effective respiratory management, resulting in inadequate ventilation. Therefore, after oxygen in the conditions, to maintain adequate ventilation, to prevent neonatal respiratory failure is of great significance.