高海拔地区围产新生儿呼吸衰竭的病因和诊断标准探讨

THE PATHOGENESIS AND DIAGNOSTIC CRITERIA OF PERINATAL RESPIRATORY FAILURE AT THE HIGH ALTITUDE

本文分析了90例围产新生儿呼吸衰竭的病因:以吸入性肺炎、缺氧缺血性脑病、颅内出血为主,围产窒息导致的呼衰占66.7％。临床诊断标准以呼吸困难、青紫为主。血气诊断指标与平原有一定的差别;西宁地区PaCO_2正常值低于平原,PaCO_2与发生急性呼衰阶差小,当PaO_2<6.67kPa, PaCO_2>5.33kPa,即作为本地区婴儿及新生儿急性呼衰的诊断标准,应按呼吸衰竭积极救抢。

This article analyzed the pathpgenesis of 90 cases of perinatal respi- ratory failure patients, it inclued:1. Pneumonia 25 cases aspirated pneu- monia 14, pulmonary hyaline membrane disease 3, wet lung disease 2;2. Central nervuous system diseases 49 cases, intracranial hemorrhage 26, hy- poxic ischemic encephalopathy 19,purulent meninigitis 4; 3. Scleredema 31 4. Papaverine intoxication 2. 66.7% of the respiratory failure were due to asphyxia of perinatal period. The clinical diagnostic criteria is respiratory difficulty, cyanosis, conscious changed and circulatory disorders. The index of blood gas is PaO_2≤6.67 Kpa, PaCO_2≥5.33 Kpa, which had some differences between the high altitude and the plain. When the patients presented PaO_2≥5.33 Kpa, were diagnosed the respiratory failure and must be rescued.