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Influencing factors of the neurodevelopment of high-risk infants 被引量:8
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作者 Yuan Tian Chuncao Zhang +3 位作者 Guangjun Yu Xiangying Hu Zheng Pu Liyu Ma 《General Psychiatry》 CSCD 2018年第6期140-145,共6页
Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of deve... Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment. 展开更多
关键词 infants high-risk FACTORS ABNORMALITIES DEVELOPMENTAL
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STUDY ON THE GROWTH OF CEREBELLUMIN NEWBORN INFANTS
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作者 张伟利 钟美萍 +1 位作者 吴圣楣 罗敏洁 《Medical Bulletin of Shanghai Jiaotong University》 CAS 2000年第1期5-7,共3页
Objective To know the growth of the cerebellum in newborn infants. Methods The centraivermian area (CVA) of the cerebellum was measured by head ultrasonography in 90 newborns including 65full - terms, 14 preterms and ... Objective To know the growth of the cerebellum in newborn infants. Methods The centraivermian area (CVA) of the cerebellum was measured by head ultrasonography in 90 newborns including 65full - terms, 14 preterms and 11 small for gestational age infants (SGA). Results The average age of the newborninfants were 4.7d (3~7d). The mean CVA in full-terms was 5.81±0.8cm2, which was significantly greater thanthat in preterms (3.7±1.0cm2), and SGA (5.1±0.8cm2), respectively. However, when corrected for birth weight(BW), the ratio of CVA/BW in term SGA was 2.07, being signoficantly higher than the ratio of 1.72 in normalfull- term newborns. There was no dillerence between male and female infants. Statistically significantrelationships were lound between CVA and BW (r=0.8129, P<0.01) and between CVA and gestational age(r=0.7450, P<0.01). Conclusion The study provide some understanding on the grouth of the cerebellum, and thecerebellar measurement by cranial ultrasound is helpful for the assessment of neurological maturation in newborninfants. 展开更多
关键词 newborn infants cerebellum neurosonography
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Eeffect of super early comprehensive rehabilitationon neurodevelopmental prognosis of high-risk infants
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作者 Qian-Jun Yue Xiao-Zhen Wang +6 位作者 Ming-Sheng Tang Jia-Ni Li Zhi-Wei Chen Yu-Qiong Zhang Xiao-Ling Huang Chun-Tao Zhang Su-Ping Li 《Journal of Hainan Medical University》 2019年第3期73-77,共5页
Objective: To observe the effect of super-early comprehensive rehabilitation intervention on neurodevelopmental prognosis of premature high-risk infants;Methods: Premature high-risk infantsmet the inclusion criteria w... Objective: To observe the effect of super-early comprehensive rehabilitation intervention on neurodevelopmental prognosis of premature high-risk infants;Methods: Premature high-risk infantsmet the inclusion criteria were divided into control group (n=30) and treatment group (n=30) according to parental willingness. The control group was given routine treatment, while the treatment group was treated with comprehensive rehabilitationon the basis of the control group. The course of treatment for both groups was 10 d. The changes of body weight, milk consumption, NBNA score, GMFM score and Gesell score were observed. Results:After treatment, the body weight and milk consumption of the treatment group increased significantly compared with those before treatment (P<0.01), which was significantly better than that of the control group (P<0.01);the NBNA score of the treatment group was higher than that of the control group at 40 weeks of gestational age (P<0.05), and the abnormal rate of NBNA was lower than that of the control group (P<0.01). The GMFM scores of A-energy and B-energy areas and the five dimensions of social adaptation, big exercise, fine exercise, language and personal social interaction in the treatment group increased significantly in 1 month, 2 months and 3 months after birth,which were significantly better than those in the control group (P<0.05 or P<0.01). Conclusion: Super-early comprehensive rehabilitation can improve the physical quality of high-risk infants and promote the development of the nervous system, with remarkable effect. 展开更多
关键词 Super- early comprehensive rehabilitation PREMATURE high-risk infants NEURODEVELOPMENT PROGNOSIS
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Early Intervention in the Neurodevelopment of Premature Infants during the First Six Months of Life 被引量:6
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作者 Irma Alvarado-Guerrero Adrián Poblano +2 位作者 Erzsebet Marosi María Corsi-Cabrera Gloria A. Otero-Ojeda 《Neuroscience & Medicine》 2011年第2期104-109,共6页
Objective: Measure the effects of Early Intervention ad modum Katona (EI-K) in high-risk premature infants by means of clinical, neurobehavioral, and neurophysiologic tests. Method: We used the Amiel-Tison neurologic ... Objective: Measure the effects of Early Intervention ad modum Katona (EI-K) in high-risk premature infants by means of clinical, neurobehavioral, and neurophysiologic tests. Method: We used the Amiel-Tison neurologic examination, the Bayley Scale of Infant Behavior, and electroencephalography (EEG) recordings at 42 weeks of conceptional age, and after 6 months of treatment EI-K (n = 14) and compared these results with those of a group of infants without early intervention (nEI) (n = 11). Results: We found better performance of infants in EI-K than nEI group after 6 months of treatment in neurologic and behavioral examination measurements, but found no differences in EEG comparisons. Conclusion: Our data suggest significant benefit of the use of EI-K program over n-EI in the neurologic and neurobe-havior examinations of premature infants after 6 months of age. 展开更多
关键词 PREMATURE high-risk infants Early INTERVENTION Brain Plasticity
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Investigation of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants
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作者 Badriul Hegar Aswitha Boediarso +1 位作者 Agus Firmansyah Yvan Vandenplas 《World Journal of Gastroenterology》 SCIE CAS CSCD 2004年第12期1795-1797,共3页
AIM:To evaluate the incidence of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants. METHODS:In a cross-sectional study at the University Outpatient Clinic for vaccination in Jakarta,138... AIM:To evaluate the incidence of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants. METHODS:In a cross-sectional study at the University Outpatient Clinic for vaccination in Jakarta,138 mothers of healthy infants less than 12-mo old were prospectively asked to report the frequency of regurgitation. RESULTS:Whatever the age was,some infants did not regurgitate(from 10% during the first month of life to 67% in 1-year-old infants).Regurgitation of at least once a day was reported in 77% of infants younger than 3 too.Daily regurgitation decreased to 12% in the 9-12 mo old group. Reported peak prevalence was 81%(26/32)during the first month of life.Regurgitation decreased sharply between the 4-6 and 7-9 mo old groups(from 44% to 9%).The longer the regurgitation persisted,the more frequently the mother perceived regurgitation as a problem.Volume and frequency of regurgitation,back arching,irritability,crying and refusal of feeding were the symptoms causing maternal anxiety.The longer the regurgitation persisted,the more frequently the mothers viewed it as a health problem. CONCLUSION:Regurgitation occurs frequently in Indonesian infants,and is a frequent cause of concern to mothers. 展开更多
关键词 Adult Cross-Sectional Studies Female Gastroesophageal Reflux Humans Indonesia infant infant newborn Irritable Mood Male Mothers Prevalence Prospective Studies
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The Distribution and Morphological Diversity of GABA-containing Neurons in The Prefrontal Cortex of Human Newborn Baby Infant
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作者 Zheng Deshu Gai Weiping 《解剖学报》 CAS 1987年第4期348-348,共1页
The prefrontal cortex of a human full termnewborn infant just after accidental death was studies by mcans of immunocytochemical technique with antibody directedagainst GABA(Immunonuclear Corp.)and ABC kit(Vector)。GAB... The prefrontal cortex of a human full termnewborn infant just after accidental death was studies by mcans of immunocytochemical technique with antibody directedagainst GABA(Immunonuclear Corp.)and ABC kit(Vector)。GABA-containing neurons were found over all layers and all were nonpyramidal cells.The laminar distribution of GABA-containing ne-urons was not even between different layers,density in laye Ⅱ was prominently higher than any other layers,density in layer Ⅲ and layer Ⅳ was higher than that in layer V and Ⅵ. 展开更多
关键词 GABA The Distribution and Morphological Diversity of GABA-containing Neurons in The Prefrontal Cortex of Human newborn Baby infant
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新生儿急性肺损伤的发病机制
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作者 杨若彤 赵国英 王浩 《基础医学与临床》 CAS 2025年第1期135-139,共5页
新生儿由于气道较窄、肺泡发育不完全等因素易发生新生儿急性肺损伤(ALI),严重者可发展为新生儿急性呼吸窘迫综合征(ARDS)。导致新生儿ALI发生及进展的机制涉及各个方面,主要包括氧化应激、铁死亡、炎性反应和肺表面活性物质的减少。期... 新生儿由于气道较窄、肺泡发育不完全等因素易发生新生儿急性肺损伤(ALI),严重者可发展为新生儿急性呼吸窘迫综合征(ARDS)。导致新生儿ALI发生及进展的机制涉及各个方面,主要包括氧化应激、铁死亡、炎性反应和肺表面活性物质的减少。期待相关机制的进一步研究可以为探索新型治疗方案提供方向。 展开更多
关键词 新生儿 急性肺损伤 急性呼吸窘迫综合征 发病机制
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呼吸窘迫综合征早产儿发生呼吸机相关性肺炎的影响因素及其风险预测列线图模型构建
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作者 许如丽 倪春梅 +3 位作者 李眉 王伏东 蒋丽军 王莉 《实用心脑肺血管病杂志》 2025年第2期27-31,共5页
目的探讨呼吸窘迫综合征(RDS)早产儿发生呼吸机相关性肺炎(VAP)的影响因素,构建并验证其风险预测列线图模型。方法选取2020年8月—2023年8月扬州大学附属医院收治的224例RDS早产儿,采用随机数字表法将早产儿按照7∶3的比例分为建模集(15... 目的探讨呼吸窘迫综合征(RDS)早产儿发生呼吸机相关性肺炎(VAP)的影响因素,构建并验证其风险预测列线图模型。方法选取2020年8月—2023年8月扬州大学附属医院收治的224例RDS早产儿,采用随机数字表法将早产儿按照7∶3的比例分为建模集(156例)与验证集(68例)。收集母亲及早产儿情况,根据是否发生VAP将建模集早产儿分为VAP组和非VAP组。采用多因素Logistic回归分析探讨RDS早产儿发生VAP的影响因素;采用R软件及rms程序包建立RDS早产儿发生VAP的风险预测列线图模型;进行Hosmer-Lemeshow拟合优度检验以评价该列线图模型的拟合程度;采用ROC曲线分析该列线图模型对RDS早产儿发生VAP的预测价值。结果建模集156例早产儿中74例发生VAP,发生率为47.44%。VAP组与非VAP组新生儿危重病例评分(NCIS)、有创机械通气时间、拔管后无创通气时间、重复插管上机次数比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,NCIS、有创机械通气时间、拔管后无创通气时间、重复插管上机次数是RDS早产儿发生VAP的独立影响因素(P<0.05)。基于上述因素构建RDS早产儿发生VAP的风险预测列线图模型。Hosmer-Lemeshow拟合优度检验结果显示,在建模集和验证集中,该列线图模型的拟合程度较好(P<0.05)。ROC曲线分析结果显示,该列线图模型预测建模集和验证集RDS早产儿发生VAP的AUC分别为0.958〔95%CI(0.914~0.999)〕、0.875〔95%CI(0.723~0.951)〕。结论NCIS、有创机械通气时间、拔管后无创通气时间、重复插管上机次数是RDS早产儿发生VAP的独立影响因素,基于上述因素构建的列线图模型对RDS早产儿发生VAP具有较好的区分能力。 展开更多
关键词 呼吸窘迫综合征 新生儿 婴儿 早产 肺炎 呼吸机相关性 影响因素分析 列线图
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Fetal programming and early identification of newborns at high risk of free radical-mediated diseases 被引量:4
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作者 Serafina Perrone Antonino Santacroce +1 位作者 Anna Picardi Giuseppe Buonocore 《World Journal of Clinical Pediatrics》 2016年第2期172-181,共10页
Nowadays metabolic syndrome represents a real outbreak affecting society. Paradoxically, pediatricians must feel involved in fighting this condition because of the latest evidences of developmental origins of adult di... Nowadays metabolic syndrome represents a real outbreak affecting society. Paradoxically, pediatricians must feel involved in fighting this condition because of the latest evidences of developmental origins of adult diseases. Fetal programming occurs when the normal fetal development is disrupted by an abnormal insult applied to a critical point in intrauterine life. Placenta assumes a pivotal role in programming the fetal experience in utero due to the adaptive changes in structure and function. Pregnancy complications such as diabetes, intrauterine growth restriction, preeclampsia, and hypoxia are associated with placental dysfunction and programming. Many experimental studies have been conducted to explain the phenotypic consequences of fetal-placental perturbations that predispose to the genesis of metabolic syndrome, obesity, diabetes, hyperinsulinemia, hypertension, and cardiovascular disease in adulthood. In recent years, elucidating the mechanisms involved in such kind of process has become the challenge of scientific research. Oxidative stress may be the general underlying mechanism that links altered placental function to fetal programming. Maternal diabetes, prenatal hypoxic/ischaemic events, inflammatory/infective insults are specific triggers for an acute increase in free radicals generation. Early identification of fetuses and newborns at high risk of oxidative damage may be crucial to decrease infant and adult morbidity. 展开更多
关键词 FETAL programming OXIDATIVE stress high-risk newborn Biomarkers PERINATAL medicine Metabolic syndrome
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“AFGP” bundles for an extremely preterm infant who underwent difficult removal of a peripherally inserted central catheter:A case report 被引量:1
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作者 Qiong Chen Yan-Ling Hu +2 位作者 Shao-Yu Su Xi Huang Ying-Xin Li 《World Journal of Clinical Cases》 SCIE 2021年第17期4253-4261,共9页
BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult rem... BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC.CASE SUMMARY Female baby A,weighing 1070 g at 27^(+1) wk of gestational age,was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome.She underwent PICC insertion twice.The first PICC insertion went well;the second PICC was inserted in the right lower extremity,however,phlebitis occurred on the second day after the placement.On the third day of catheterization,phlebitis was aggravated,while the right leg circumference increased by 2.5 cm.On the fourth day of catheterization,more red swelling was found in the popliteal part,covering an area of about 1.5 cm×4 cm,which was diagnosed as phlebitis level 3;thus,we decided to remove the PICC.During tube removal,the catheter rebounded and could not be pulled out(several conventional methods were performed).Finally,we successfully removed the PICC using a new approach termed“AFGP”.On the 36th day of admission,the baby fully recovered and was discharged.CONCLUSION The“AFGP”bundle approach was effective for an extremely preterm infant,who underwent level 3 difficult removal of a PICC. 展开更多
关键词 infant newborn Extremely preterm infant Catheterization Peripheral Nursing Complications Case report
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Effect of caffeine in the intraventricular hemorrhage of the preterm newborn
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作者 Pilar Alves-Martinez Monica Garcia-Alloza 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第9期1942-1943,共2页
There are around 15 million preterm newborns(PT) eve ry year(Atienza-Navarro et al., 2020).With these figures in mind,prematurity represents a major health problem worldwide and it is a leading cause of infant mortali... There are around 15 million preterm newborns(PT) eve ry year(Atienza-Navarro et al., 2020).With these figures in mind,prematurity represents a major health problem worldwide and it is a leading cause of infant mortality,accounting for up to 35%of all deaths among newborns(Atienza-Navarro et al.,2020) and up to 18% of the deaths among children under 5 years of age. 展开更多
关键词 newborn infant DEATHS
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Oxidative stress and free radicals related diseases of the newborn
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作者 Serafina Perrone Maria Luisa Tataranno +1 位作者 Gemma Stazzoni Giuseppe Buonocore 《Advances in Bioscience and Biotechnology》 2012年第7期1043-1050,共8页
Free radicals (FRs) generation is an unavoidable consequence of the life in an oxygen-rich atmosphere. FRs can be considered a double-edged sword. Beneficial effects of FRs occur at moderate concentrations and involve... Free radicals (FRs) generation is an unavoidable consequence of the life in an oxygen-rich atmosphere. FRs can be considered a double-edged sword. Beneficial effects of FRs occur at moderate concentrations and involve physiological roles in cellular responses to noxia, as in defense against infectious agents, in the function of a number of cellular signaling pathways and the induction of a mitogenic response. The over-production of FRs and the insufficiency of an antioxidant mechanism result in oxidative stress (OS), a deleterious process and important mediator of damage to cell structures and tissues. It occurs at birth in all newborns as a consequence of the hyperoxic challenge after the transition from the hypoxic intrauterine environment to extrauterine life. During the perinatal period, OS can be magnified by others predisposing conditions such as hyperoxia, hypoxia, ischemia, hypoxia-reperfusion, inflammation and high levels of non-protein bound iron. Epidemiological studies linked OS occurring during fetal stages and early infancy with adverse health outcomes later in life, indicating that OS is an early event in the etiology of these chronic diseases. Newborns, especially if preterm, are particularly susceptible to OS and damage due to the increased generation of FRs, the lack of adequate antioxidant protection, and the inability to induce antioxidant defenses during the hyperoxic challenge at birth. This impairment of the oxidative balance has been thought to be the common factor of pathologies grouped together as “free radical disease in the neonate” that include retinopathy of prematurity (which may lead to blindness in severe cases), bronchopulmonary dysplasia (a particularly debilitating pulmonary lesion of the preterm infant), periventricular leukomalacia (an important cause of severe neurodisability) and necrotizing enterocolitis. In this review we discuss in detail these perinatal diseases. Particularly, we analyze the current knowledge about the role of OS in their pathogenesis. 展开更多
关键词 newborn infant Free RADICALS PERINATAL Diseases OXIDATIVE Stress
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不同种类病原体导致的新生儿中枢神经系统感染临床及实验室特征分析
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作者 蒲伟丛 刘玉 +3 位作者 王乐 郭映辉 孙敏 马莉 《河北医科大学学报》 CAS 2024年第10期1168-1174,共7页
目的分析不同种类病原体导致的新生儿中枢神经系统(central nervous system,CNS)感染的临床特征、实验室检查及临床转归。方法回顾性收集2020年1月1日—2022年12月31日河北省儿童医院新生儿重症监护室收治并明确病原体的CNS感染患儿的... 目的分析不同种类病原体导致的新生儿中枢神经系统(central nervous system,CNS)感染的临床特征、实验室检查及临床转归。方法回顾性收集2020年1月1日—2022年12月31日河北省儿童医院新生儿重症监护室收治并明确病原体的CNS感染患儿的病历资料,依据病原学结果分为细菌性脑膜炎(bacterial meningitis,BM)与病毒性脑膜炎(viral meningitis,VM)组,比较2组的临床特征、实验室结果及转归。结果共纳入63例患儿,BM组38例,VM组25例,胎龄中位值38.3(3.0)周,足月儿47例(74.6%),男性37例(58.7%),平均出生体重(2970±731)g,发病日龄中位值为9.6(11.0)d,主要临床表现包括发热(55例,87.3%)、黄疸(29例,46.0%)、吃奶差(20例,31.7%)、肌张力异常(20例,31.7%)等,2组一般临床特征及临床表现差异无统计学意义(P>0.05)。BM组脑脊液(cerebrospinal fluid,CSF)白细胞(white blood cell,WBC)计数、WBC异常比例、多核细胞百分比、蛋白水平及血WBC计数、中性粒细胞百分比、CRP及CRP>8 mg/L的比例均显著高于VM组(P<0.05)。BM组CSF WBC范围在6~258233个/mm^(3)之间,1例CSF WBC低于20个/mm^(3)。VM组CSF WBC范围在1~1238个/mm^(3)之间,2例CSF WBC高于1000个/mm^(3),9例低于20个/mm^(3)。BM组病原体以大肠埃希菌(11例,28.9%)、肺炎克雷伯菌(6例,15.8%)最常见。VM组病原体以肠道病毒最常见(15例,60%)。随访结果显示BM组1例死亡,3例遗留严重的神经系统后遗症,VM组3例死亡,1例遗留严重的神经系统后遗症,其余全部预后良好。结论仅通过临床特征难以区分新生儿CNS感染是由细菌或病毒所致,常规实验室检查在判断致病病原体上有一定帮助,开展包含病毒靶标在内的脑脊液病原检测对实现精准治疗及改善预后至关重要。 展开更多
关键词 中枢神经系统感染 病原体 婴儿 新生
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新生儿肾上腺囊性神经母细胞瘤临床及CT表现
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作者 梁琼鹤 管红梅 +2 位作者 蒋维维 盛会雪 王颖 《中国医学影像技术》 CSCD 北大核心 2024年第9期1386-1389,共4页
目的观察新生儿肾上腺囊性神经母细胞瘤(CNB)的临床及CT表现。方法回顾性分析经手术病理确诊的8例新生儿肾上腺CNB,记录其临床资料,观察术前全腹CT平扫及增强表现。结果8例中,6例(6/8,75.00%)于胎儿期、2例(2/8,25.00%)于新生儿期经超... 目的观察新生儿肾上腺囊性神经母细胞瘤(CNB)的临床及CT表现。方法回顾性分析经手术病理确诊的8例新生儿肾上腺CNB,记录其临床资料,观察术前全腹CT平扫及增强表现。结果8例中,6例(6/8,75.00%)于胎儿期、2例(2/8,25.00%)于新生儿期经超声检出;均见单侧肾上腺单发病灶,位于左、右侧肾上腺各4个(4/8,50.00%),最大径2.3~6.1 cm、中位最大径4.5 cm。CT显示8个(8/8,100%)病灶均表现为局限性厚壁囊性肿块,其中3个(3/8,37.50%)囊内密度均匀、3个(3/8,37.50%)囊内有分隔、1个(1/8,12.50%)囊内见少许漂浮物、1个(1/8,12.50%)囊内同时存在分隔及漂浮物,均未见钙化;病灶均未见跨越中线、均无血管包绕,7个(7/8,87.50%)边界清晰、1个(1/8,12.50%)边界欠清,均轻度推压周围结构;增强后囊壁及分隔轻度强化。2例累及肝脏。结论新生儿肾上腺CNB多于胎儿期检出,CT主要表现为厚壁囊性肿块,边界清晰,内可有分隔及漂浮物,增强后囊壁及分隔轻度强化;可出现肝脏转移。 展开更多
关键词 婴儿 新生儿 肾上腺肿瘤 神经母细胞瘤 体层摄影术 X线计算机
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基于需求理论的综合干预对CDAS围手术期新生儿康复质量及NIPS评分的影响
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作者 刘娟 杨延洁 +2 位作者 王晶 唐春 巴依尔才次克 《河北医药》 CAS 2024年第13期1960-1964,共5页
目的 探讨基于需求理论的综合干预对先天性十二指肠闭锁与狭窄(CDAS)围手术期新生儿康复质量及新生儿疼痛评估量表(NIPS)评分的影响。方法 选取2016年1月至2018年1月收治的新生儿CDAS患者137例进行回顾分析,按随机数字表法分为试验组(n=... 目的 探讨基于需求理论的综合干预对先天性十二指肠闭锁与狭窄(CDAS)围手术期新生儿康复质量及新生儿疼痛评估量表(NIPS)评分的影响。方法 选取2016年1月至2018年1月收治的新生儿CDAS患者137例进行回顾分析,按随机数字表法分为试验组(n=69)和对照组(n=68),其中试验组在围手术期均予以基于需求理论的综合干预,对照组则单纯予以常规干预,比较2组患儿康复质量及两种干预方法对NIPS评分的影响。结果 2组干预前D-乳酸、二胺氧化酶(DAO)、内毒素比较差异无统计学意义(P>0.05);干预后试验组上述3项指标均低于对照组(P<0.05)。CDAS严重程度与D-乳酸、DAO、内毒素水平高低呈正相关(P<0.05)。2组干预前白细胞(WBC)、血小板(PLT)、C反应蛋白(CRP)及降钙素原(PCT)比较差异无统计学意义(P>0.05);干预后试验组上述4项指标均低于对照组(P<0.05)。CDAS严重程度与PLT、CRP、PCT水平呈正相关(P<0.05)。试验组留置胃管时间、首次排气时间均短于对照组(P<0.05),试验组术后并发症发生率显著低于对照组(P<0.05)。2组干预前的面部表情、哭吵、呼吸形式、上肢形态、下肢形态及觉醒状态的单项分、总分比较差异无统计学意义(P>0.05);干预后试验组上述指标的单项分、总分均低于对照组(P<0.05),且CDAS严重程度与NIPS评分高低呈正相关(P<0.05)。结论 在CDAS患儿的围手术期干预中科学、合理的实施基于需求理论的综合干预能有效提升患儿康复质量,降低NIPS评分表达,有较好的临床应用价值。 展开更多
关键词 基于需求理论的综合干预 新生儿 先天性十二指肠闭锁与狭窄 康复质量 新生儿疼痛评估量表
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新凝血标志物在新生儿弥漫性血管内凝血诊断及预后评估中的价值
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作者 张世杰 孟宪春 +2 位作者 孙萍萍 杨静静 吴静 《天津医药》 CAS 2024年第2期206-210,共5页
目的探讨新凝血标志物血栓调节蛋白(TM)、凝血酶-抗凝血酶复合物(TAT)、纤溶酶-α2抗纤溶酶复合物(PIC)和组织型纤溶酶原激活剂-纤溶酶原激活剂抑制剂-1复合物(t-PAIC)在新生儿弥漫性血管内凝血(DIC)诊断及预后评估中的价值。方法纳入87... 目的探讨新凝血标志物血栓调节蛋白(TM)、凝血酶-抗凝血酶复合物(TAT)、纤溶酶-α2抗纤溶酶复合物(PIC)和组织型纤溶酶原激活剂-纤溶酶原激活剂抑制剂-1复合物(t-PAIC)在新生儿弥漫性血管内凝血(DIC)诊断及预后评估中的价值。方法纳入87例DIC患儿(观察组),根据其出院时的转归情况分为存活组(66例)和死亡组(21例),另外以同期出生的50例健康新生儿作为对照组。收集新生儿的临床资料,采用Logistic回归分析新生儿发生DIC的危险因素。分析不同组别TM、TAT、PIC和t-PAIC水平差异。采用受试者工作特征(ROC)曲线分析TM、TAT、PIC和t-PAIC在新生儿DIC诊断和预后评估中的价值。结果观察组低Apgar评分、出生窒息、IVH、脓毒症和PIH的发生率高于对照组(P<0.05)。多因素Logistic回归分析显示,低Apgar评分、出生窒息、脓毒症和PIH是新生儿发生DIC的独立危险因素。观察组TM、TAT、PIC和t-PAIC水平均高于对照组(P<0.05)。ROC曲线显示,TM、TAT、PIC和t-PAIC联合诊断新生儿DIC的价值优于单独诊断。死亡组TM、TAT水平高于存活组(P<0.05),2组PIC、t-PAIC差异无统计学意义;多因素Logistic回归分析显示,TAT水平升高是影响新生儿DIC预后的独立危险因素。ROC曲线显示,当TAT为21.72μg/L时,其预测新生儿DIC预后的曲线下面积为0.772(95%CI:0.666~0.878),敏感度和特异度分别为76.2%和71.2%。结论TM、TAT、PIC和t-PAIC联合应用对新生儿DIC诊断和预后评估具有重要的临床价值。 展开更多
关键词 婴儿 新生 疾病 弥漫性血管内凝血 血栓调节蛋白 凝血酶-抗凝血酶复合物 纤溶酶-α2抗纤溶酶复合物 组织型纤溶酶原激活剂-纤溶酶原激活剂抑制剂-1复合物
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新生儿及婴儿急诊消化道手术围麻醉期风险探讨
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作者 尹红 刘双梅 +1 位作者 刘猛 王额尔敦 《精准医学杂志》 2024年第6期523-526,共4页
目的分析新生儿及婴儿急诊消化道手术麻醉诱导、维持、苏醒期以及术后并发症,为此类麻醉提供参考数据。方法回顾性分析我院196例行急腹症手术的新生儿和婴儿的临床资料,按照患儿年龄分为新生儿组(N组,≤30 d)115例和婴儿组(I组,30 d~6... 目的分析新生儿及婴儿急诊消化道手术麻醉诱导、维持、苏醒期以及术后并发症,为此类麻醉提供参考数据。方法回顾性分析我院196例行急腹症手术的新生儿和婴儿的临床资料,按照患儿年龄分为新生儿组(N组,≤30 d)115例和婴儿组(I组,30 d~6个月龄)81例,收集两组患儿的一般资料、疾病分布、术中及术后并发症发生情况。结果两组体质量(t=-8.517,P<0.05)、低体质量儿比例(χ^(2)=64.909,P<0.05)、早产儿比例(χ^(2)=10.657,P<0.05)、合并先心病比例(χ^(2)=5.210,P<0.05)、合并感染性休克及代谢性酸中毒比例(χ^(2)=8.728,P<0.05)差异具有显著性。N组更易出现麻醉维持阶段低氧血症(χ^(2)=4.123,P<0.05)、低体温(χ^(2)=8.792,P<0.05)以及低血糖(χ^(2)=4.074,P<0.05)。N组术后呼吸支持率(χ^(2)=5.474,P<0.05)、多器官功能衰竭发生率(χ^(2)=5.474,P<0.05)、住院天数(t=4.636,P<0.05)高于I组。结论新生儿及婴儿消化道急诊手术围手术期麻醉相关并发症发生率高,其中新生儿发生低氧血症、低血糖、低体温及呼吸暂停风险明显高于婴儿群体。新生儿急诊外科手术在呼吸道麻醉风险管理中值得重视。 展开更多
关键词 消化系统外科手术围 手术期 麻醉 手术中并发症 婴儿 新生
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LISA技术治疗超低出生体质量儿呼吸窘迫综合征28例 被引量:1
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作者 赵明明 刘玉娟 +1 位作者 李忠良 刘小娜 《安徽医药》 CAS 2024年第1期143-147,共5页
目的探讨经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)下经微管气管内注入肺表面活性物质(less invasive surfactant administration,LISA)技术在超低出生体质量儿呼吸窘迫综合征(respiratory distress synd... 目的探讨经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)下经微管气管内注入肺表面活性物质(less invasive surfactant administration,LISA)技术在超低出生体质量儿呼吸窘迫综合征(respiratory distress syndrome,RDS)治疗中的应用与疗效。方法采取前瞻性研究方法,选取潍坊市妇幼保健院新生儿科重症监护病房(neonatalintensive careunit,NICU)2019年7月至2021年4月收治的超低出生体质量儿(58例)为研究对象。应用随机数字表法分为LISA组(28例)和气管插管-注入PS-拔管给予经鼻持续气道正压通气(intubation-surfactant-extubation,INSURE)组(30例)。LISA组采用LISA技术,在nCPAP下,气管内置入微管并注入肺表面活性物质(pulmonarysurfactant,PS);INSURE组采用INSURE技术,拔管后给予nCPAP辅助通气。观察并比较两组病儿给药过程、给药前后呼吸机参数、动脉血气、用氧时间及并发症的发生率。结果LISA组病儿72 h内机械通气率低于INSURE组,差异有统计学意义(21.4%比46.7%,P=0.043);LISA组病儿住院期间无创正压通气时间(404.50 h比483.50 h,P=0.033)及总用氧时间(520.00 h比612.50 h,P=0.040)低于INSURE组;LISA组给药1 h后动脉血氧分压(arterial partialpressureof O_(2),PaO_(2))变化高于INSURE组[(54.29±5.69)mmHg比(52.87±3.27)mmHg,P=0.038],差异有统计学意义;LISA组支气管肺发育不良(25.0%比53.3%,P=0.028)及有血流动力学意义的动脉导管未闭发生率(28.6%比56.7%,P=0.031)低于INSURE组,均差异有统计学意义。结论在超低出生体质量儿RDS治疗中,LISA技术在减少72 h内机械通气率、住院期间用氧时间、近期并发症等方面具有优势,是一种安全有效的治疗超低出生体质量儿RDS的方法。 展开更多
关键词 呼吸窘迫综合征 新生儿 肺表面活性物质相关蛋白质类 连续气道正压通气 经微管气管内注入肺表面活性物质(LISA) 婴儿 超低出生体质量
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新生儿颅骨凹陷骨折手术治疗
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作者 刘渤 谢仕刚 +1 位作者 岳喜赞 王广宇 《中国现代神经疾病杂志》 CAS 北大核心 2024年第10期821-826,共6页
目的探讨新生儿颅骨凹陷骨折的手术方式。方法与结果纳入2021年1月至2023年12月在山东大学附属儿童医院进行手术治疗的8例新生儿颅骨凹陷骨折患儿,术前均行头部CT薄层扫描+颅骨三维重建,根据凹陷部位、范围和深度,分别予以凹陷边缘钻孔... 目的探讨新生儿颅骨凹陷骨折的手术方式。方法与结果纳入2021年1月至2023年12月在山东大学附属儿童医院进行手术治疗的8例新生儿颅骨凹陷骨折患儿,术前均行头部CT薄层扫描+颅骨三维重建,根据凹陷部位、范围和深度,分别予以凹陷边缘钻孔,骨撬撬起凹陷颅骨复位(3例);骨撬撬起后凹陷颅骨再次塌陷,延长切口显露全部凹陷区域,将塑形后的可吸收连接片固定于撬起后复位的凹陷区域(2例);前囟外侧角处钝性分离颅骨和硬脑膜,深入骨撬撬起凹陷颅骨复位(1例);凹陷边缘冠状缝处钝性分离颅骨和硬脑膜,深入骨撬撬起凹陷颅骨复位(2例)。术后第1天复查头部CT均显示凹陷复位良好。1例合并凹陷区域外线性骨折患儿骨折自然愈合,1例合并硬膜外出血患儿血肿自行吸收。平均随访6.80个月,复查头部CT均显示颅骨发育正常,无再次颅骨凹陷。结论手术治疗可以即刻复位颅骨凹陷骨折,对于邻近前囟或骨缝的骨折,可以通过前囟外侧角或未闭合的骨缝撬起凹陷,这一术式更为微创。 展开更多
关键词 颅骨骨折 婴儿 新生 神经外科手术
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孕妇肠道、阴道菌群和新生儿胎粪、胎皮脂菌群的相关性研究
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作者 马锦倩 范翩翩 +4 位作者 郑涛 张琳 陈远志 申剑 欧阳凤秀 《上海交通大学学报(医学版)》 CAS CSCD 北大核心 2024年第1期50-63,共14页
目的·分析母亲孕晚期肠道菌群、阴道菌群、新生儿胎粪及胎皮脂菌群的多样性及菌群构成,比较其异同及相关性。方法·前瞻性研究。招募2018年8月—11月于上海交通大学医学院附属新华医院分娩的11对母婴,采集母亲孕晚期粪便样本... 目的·分析母亲孕晚期肠道菌群、阴道菌群、新生儿胎粪及胎皮脂菌群的多样性及菌群构成,比较其异同及相关性。方法·前瞻性研究。招募2018年8月—11月于上海交通大学医学院附属新华医院分娩的11对母婴,采集母亲孕晚期粪便样本、阴道拭子及新生儿胎粪;招募2018年12月于上海交通大学医学院附属国际和平妇幼保健院分娩的14名新生儿,采集额部、腋窝、腹股沟部位的胎皮脂及胎粪样本。所有孕妇均为阴道自然分娩。采用16S rRNA基因V3~V4区测序进行微生物检测,分析11对母婴中母亲的肠道菌群、阴道菌群和新生儿的胎粪菌群,以及14名新生儿的胎皮脂菌群和胎粪菌群的多样性、菌群构成,分析异同及相关性。结果·母亲肠道菌群的操作分类单元(operational taxonomic unit,OTU)数、Ace指数、Chao1指数、Shannon指数均高于阴道菌群和新生儿胎粪菌群;新生儿3个部位胎皮脂菌群的Ace指数和Chao1指数均显著高于胎粪菌群(均P<0.01)。母亲肠道菌群、阴道菌群和新生儿胎粪菌群β多样性存在差异(P<0.01);新生儿额部、腋窝和腹股沟3个部位胎皮脂菌群的β多样性相似,但与胎粪菌群存在差异(P<0.01)。在门水平上,母亲肠道菌群优势菌主要为厚壁菌门(Firmicutes,52.76%)和拟杆菌门(Bacteroidetes,41.67%),阴道菌群优势菌为厚壁菌门(74.36%)和放线菌门(Actinobacteria,21.25%),胎皮脂菌群的优势菌为厚壁菌门(84.22%)和变形菌门(Proteobacteria,8.80%),新生儿胎粪菌群在2个批次样本中优势菌均为变形菌门(分别占81.11%和88.72%)。在属水平上,母亲肠道菌群的优势菌为拟杆菌属(Bacteroides,35.42%)和栖粪杆菌属(Faecalibacterium,10.12%),阴道菌群的优势菌为乳杆菌属(Lactobacillus,69.10%)和双歧杆菌属(Bifidobacterium,11.30%),胎皮脂菌群的优势菌为乳杆菌属(79.81%)和假单胞菌属(Pseudomonas,3.23%),胎粪菌群的优势菌在2个批次样本中均为埃希菌属(Escherichia,分别占55.21%和31.18%)。结论·母亲孕晚期肠道菌群的α多样性高于阴道菌群和新生儿胎粪菌群,新生儿胎皮脂菌群α多样性高于胎粪菌群。厚壁菌门在母亲孕晚期肠道菌群、阴道菌群及新生儿胎皮脂菌群中均为优势菌,乳杆菌属在母亲阴道菌群及新生儿胎皮脂菌群中均为优势菌,胎粪菌群以变形菌门和埃希菌属较多。新生儿不同身体部位的胎皮脂菌群结构相似,但与胎粪菌群存在差异。 展开更多
关键词 母婴菌群的垂直传递 肠道菌群 阴道菌群 胎粪菌群 胎皮脂菌群 新生儿
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