新生兒疾病neonatal_disease

1、Neonatal Problems,,Defination,Neonate-- 新生兒 0—28 days Infant--嬰兒28 days—1 years old.,Definition of Neonate(1): related to GA（ gestational age）,Preterm/ premature neonate:<37 w 早產(chǎn)兒 Term neonate:

2、 37～42 w 足月兒 Post-term neonate: ≥42 w 過(guò)期產(chǎn)兒,How to identify 怎樣識(shí)別,skinhead and hairearThenar（手掌）Galactophore（乳腺）Genitalia(生殖器),Difference of term and preterm skin 皮膚

3、,Difference of term and preterm thenar 足紋,,Difference of term and preterm galactophore乳腺,Difference of term and preterm ear conch耳殼,Difference of term and

4、 preterm genitalia 生殖器,Difference of term and preterm head and hair頭部及毛發(fā),Definition of Neonate(2): related to BW（birth weight）,（measure within 1st hour after birth）Tiny baby

5、 BW4000g,Definition of Neonate(3): related to both GA & BW,Small for gestational age SGA 小于胎齡兒Appropriated for gestational age AGA

6、 適于胎齡兒Large for gestational age LGA 大于胎齡兒,Definition of Neonate(4): related to age,Early baby (perinatal baby):早期新生兒 n

7、eonate in first 7 days Late baby : 晚期新生兒 above 7 days,Definition of Neonate(5): High risk baby 高危新生兒,Is the baby who have severe conditions and need intensive care af

8、ter birth, usually are those with maternal disease or abnormal delivery history. e.g, preterm baby, asphyxia （窒息）, congenital disease（先天性疾病），ect.,Some Common Diseases,Hyaline Membrane Disease (HMD)AsphyxiaHypoxic i

9、schaemic encephalopathy(HIE) PneumoniaPulmonary HemorrhageJaundice,新生兒黃疸 (Neonatal Jaundice),Definition,The yellow skin and mucus because of too high concentration of bilirubin in the blood.,Two types of neonatal

10、 jaundices,neonatal jaundices physiological pathological 生理性黃疸 病理性黃疸,,,Comparison,Pathological jaundice（remember）,Onset too early 出現(xiàn)早Bilirubin level too high

11、水平高Increase too fast 發(fā)展快Disappear too late 消褪晚 D.bilirubin level too high 直接高 Return 易反復(fù) （很重要，要記?。?Classification of jaundice,Unconjugated

12、 hyperbilirubinemia (avoid kernicterus)Conjugated hyperbilirubinemia (early diagnosis of biliary atresia),Management,Unconjugated hyperbilirubinemiaPhototherapy：wavelength 450nmAlbumin therapy Activat

13、or of enzyme：phenobarbital 5mg, nikethamide 100mg，tid for 3～5dBlood transfusion,,,Management,Conjugated hyperbilirubinemia usually need etiological treatment or surgery operation,新生兒肺炎 Neonate Pneumonia,Diagnosi

14、s,Antepartum pneumonia : early-onset within 24 h after birth, CMV, TOX, Ecoli, GBS are usual pathogensPostpartum pneumonia: same as pneumonia in children but usually severe , Virus, bacterium, fungus all can be the pa

15、thogen,Manifestation,Irregular breathingApneaTachypneaNasal flaringthree depression sign(sternal, intercostal, subcostal)Cyanosis,Diagnosis,Clinical Manifestation: irregular breathing,dyspnea,tachypnea etcRadiolog

16、ical Findings:some patchy shadows,empyema,atelectasis,pneumothorax can be seen,X-ray,pneumonia,atelectasis,X-ray,pneumothorax,pleural effusion,Treatment,Respiratory tract management (slap back, suction,nebulization)

17、Oxygen therapy(avoid ROP)Antibiotics Others: balance of energy & acid- base, electrolytes, etc,What diseases we will see in clinic?,Asphyxia of newbornNeonatal jaundiceNeonatal hypoxic-ischaemic encephalopathyne