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目的探讨广西玉林57例新生儿肺出血的诊疗规律。方法回顾2005年1月—2007年12月收治的57例新生儿肺出血病例,分析发病时间,高危因素,诊断,治疗及治疗结果。结果肺出血的高危因素为:代谢性酸中毒,缺氧,感染,心肌损害,弥散性血管内凝血,胆红素脑病,低体温-寒冷损伤,先天性心脏病;实验室检查结果:血小板均值及血红蛋白均值降低,凝血功能均值改变、心肌酶均值增高,血气分析均值呈酸中毒改变。结论有高危因素的新生儿,出现呼吸改变,青紫,肺部罗音从无到有或增多,应尽快行X线胸片检查,并动态观察及监测血气分析,血小板、凝血功能,心肌酶,血色素,必要时应立即气管插管吸引,若吸出血性液体可诊断肺出血。对于肺出血合并D IC患儿,可给予微量肝素皮下注射,效果较好。
Objective To investigate the diagnosis and treatment of 57 cases of neonatal pulmonary hemorrhage in Yulin, Guangxi. Methods 57 cases of neonatal pulmonary hemorrhage admitted from January 2005 to December 2007 were retrospectively analyzed. The onset time, risk factors, diagnosis, treatment and treatment results were analyzed. Results High risk factors for pulmonary hemorrhage were metabolic acidosis, hypoxia, infection, myocardial damage, disseminated intravascular coagulation, bilirubin encephalopathy, hypothermia-cold injury and congenital heart disease. Laboratory test results: mean platelet count And mean of hemoglobin decreased, the average value of coagulation changed, the mean value of myocardial enzyme increased, blood gas analysis mean acidosis changed. Conclusion Newborns with high risk factors, respiratory changes, bruising, lung rales from scratch or increase, as soon as possible X-ray examination, and dynamic observation and monitoring of blood gas analysis, platelets, coagulation, myocardial enzymes, Hemoglobin, if necessary, should be immediately tracheal intubation to attract, if sucked bloody fluid can be diagnosed pulmonary hemorrhage. For pulmonary hemorrhage with ICD children, subcutaneous injection of trace heparin may be given, the effect is better.