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本文作者对其所在新生儿重症监护病房所救治的32例危重新生儿硬肿症进行了总结,指出复温时环境温度与体温相差不超过2℃,不致于引起周围毛细血管急剧扩张而影响血液循环的重新分配,体温上升速度控制在0.5℃/小时,可防止血循环短期内迅速增快而加重心脏负担导致心功能不全,要求病情愈重,复温速度愈应严格控制;指出硬肿症复温时输液的目的是纠酸和使用血管活性药物,改善微循环,必须严格控制液体入量和速度,本组病人输液速度为4.1ml/公斤/小时,多巴胺浓度为2.5—5.0μg/公斤/分,并认为此速度不致于引起血容量增加和心功能不全;本文认为肺出血和缺氧、红细胞增多症无明显关系,而和复温过程中开始排尿的时间有关,从而指出肿硬症发生肺出血可能与复温过程中血容量增多有关,最后本文指出了认识、处理硬肿症患儿急性肾功能衰竭的重要性。
The authors summarize the 32 cases of severe neonatal sclerema in their neonatal intensive care unit and point out that the difference between the ambient temperature and body temperature during rewarming does not exceed 2 ℃ and will not cause the peripheral capillaries to expand rapidly and affect the blood Circulation redistribution, body temperature rise rate control at 0.5 ℃ / hour, to prevent rapid short-term rapid increase in blood circulation and increase the burden on the heart lead to cardiac insufficiency, requiring more serious illness, rewarming speed should be strictly controlled; pointed scrotum complex The purpose of warm infusion is to correct acid and the use of vasoactive drugs to improve microcirculation, the amount and speed of fluid must be strictly controlled, the infusion rate of this group of patients 4.1ml / kg / h, dopamine concentration 2.5-5.0μg / kg / Points, and that this rate will not cause increased blood volume and cardiac insufficiency; this paper that the pulmonary hemorrhage and hypoxia, polycythemia no significant relationship, and the process of re-temperature urination started during the time, indicating that the occurrence of swollen disease Pulmonary hemorrhage may be associated with increased blood volume during rewarming. Finally, the paper points out the importance of understanding and treating acute renal failure in children with scleredema.