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目的:分析中度海拔地区新生儿窒息与红细胞增多症的关系,观察其微循环流态的变化。方法:对围产期有窒息史或羊水污染的患儿于入院后24h做血细胞分析、血气分析及耳廓微循环流态观察。结果:新生儿窒息组Hb、HCT、RBC三项值明显高于对照组。85例血气分析结果显示:27例为代谢性酸中毒,10例为呼吸性酸中毒,15例为混合型酸中毒,18例为Ⅰ型呼衰,8例为Ⅱ型呼衰。45例耳廓微循环观察综合判断显示:中度异常20例(44.4%),轻度异常18例(40.0%),大致正常5例(11.1%),正常2例(4.4%)。结论:由于中度海拔地区胎儿在宫内即处于低氧状态,慢性缺氧导致代偿性红细胞生成素(RSF)分泌增多,在窒息早期即可表现有局部或全身微循环改变、红细胞聚集、血流缓慢、瘀滞引起组织缺氧中毒,严重时可导致呼吸衰竭。
OBJECTIVE: To analyze the relationship between neonatal asphyxia and polycythemia at moderate altitude and observe the change of its microcirculation flow pattern. Methods: Perinatal asphyxia history or amniotic fluid contamination in children after admission at 24h blood analysis, blood gas analysis and auricle microcirculation flow observation. Results: The values of Hb, HCT and RBC in neonatal asphyxia group were significantly higher than those in control group. 85 cases of blood gas analysis showed that: 27 cases of metabolic acidosis, respiratory acidosis in 10 cases, 15 cases of mixed acidosis, 18 cases of type Ⅰ respiratory failure, 8 cases of type Ⅱ respiratory failure. A total of 45 cases of auricle microcirculation observed comprehensive assessment showed that: moderate abnormalities in 20 cases (44.4%), mild abnormalities in 18 cases (40.0%), roughly normal in 5 cases (11.1%), normal in 2 cases (4.4%). CONCLUSION: Chronic hypoxia leads to increased secretion of compensatory erythropoietin (RSF) due to hypoxia in the uterus of the fetus at moderate altitude. Changes in local or systemic microcirculation, aggregation of erythrocytes, Slow blood flow, stasis caused by tissue hypoxia poisoning, severe cases can lead to respiratory failure.