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目的:探讨新生儿肺出血的危险因素和早期诊断方法。方法:回顾性研究新生儿肺出血56例,分析高危因素及早期诊断方法。结果:56例肺出血的新生儿,早产、低体重、男婴发生率分别为58.93%、71.43%、76.79%,是生理性高危因素;原发病中重度窒息、感染、肺透明膜病、硬肿症、胎粪吸入综合征、肺动脉高压、先天性心脏病、胆红素脑病发生率分别为30.36%、19.64%、14.29%、12.5%、8.93%、7.14%、3.57%、3.57%,是病理性高危因素。肺出血前30 m in~4 h其临床症状和体征均有明显改变。有肺部湿罗音与无肺部湿罗音高危因素比较无显著性差异,但在死亡数及出现肺出血至死亡时间比较有显著性差异(P<0.05)。提示具有相同的危险因素,无肺部湿罗音进展及死亡均更快。气管插管行气管内吸引与口鼻涌血诊断肺出血在肺出血时间、死亡数、治愈数比较有显著性差异(P<0.05),气管内吸引更能早期发现,避免误诊,有助于及时治疗。结论:有严重原发病的高危新生儿出现紫绀苍白加重、呼吸心率改变、肺部湿罗音出现或增多、气管插管吸出血性痰可早期诊断肺出血,早期诊断是提高治疗效果的关鍵。
Objective: To explore the risk factors and early diagnosis of neonatal pulmonary hemorrhage. Methods: A retrospective study of neonatal pulmonary hemorrhage in 56 cases, analysis of risk factors and early diagnosis. Results: The incidence of neonatal 56 cases of pulmonary hemorrhage, preterm birth, low birth weight and male infant were 58.93%, 71.43% and 76.79%, respectively, which were physiological risk factors. The primary diseases were severe asphyxia, infection, hyaline membrane disease, The incidence of scleredema, meconium aspiration syndrome, pulmonary hypertension, congenital heart disease and bilirubin encephalopathy were 30.36%, 19.64%, 14.29%, 12.5%, 8.93%, 7.14%, 3.57%, 3.57% Pathological risk factors. The clinical symptoms and signs of lung were significantly changed 30 m in ~ 4 h before pulmonary hemorrhage. There was no significant difference between the wet rales of the lungs and the risk of non-pulmonary wet rales, but there was a significant difference between the number of death and the time of pulmonary hemorrhage to death (P <0.05). Prompted to have the same risk factors, lung wet rales progress and death are faster. Endotracheal intubation tracheal intubation and nasal discharge in the diagnosis of pulmonary hemorrhage in pulmonary hemorrhage time, the number of deaths, the number of cure was significantly different (P <0.05), tracheal suction more early detection, to avoid misdiagnosis, contribute to Timely treatment. CONCLUSIONS: High-risk neonates with severe primary disease have increased paleness of cyanosis, altered respiratory rate, presence or increase of wet rales in the lungs, and early detection of pulmonary hemorrhage due to bloody sputum aspiration of the endotracheal tube. Early diagnosis is the key to improving the therapeutic effect .