汕头大学医学院儿科学课件 Neonates and Disturbances in Newbowns.pptVIP

Cold Injury Syndrome Clinical Manifestation 1 clssification: early type within 7d; late type: after 7d. * Neonates and Disturbances in Newbowns Etiology relate to cold, premature, hypoxia and infection 1. endopathic causes 1.1 poor regulate function of body temperature; 1.2 subcutaneous fat are rich of saturated fatty acid; 1.3 less “brown fat”→produce heat↓ 2. exopathic cause: cold, premature, hypoxia infection, etc. Pathogenesis Immature thermotaxic center relative large body surface cold, lack of intaking infection, anoxia Insufficient heat produce of brown fat Body T anoxia, acidosis spasm of skin vassal tissue hypoxia microcirculation disturbance Rich of saturated fatty acid at high fusioon point coagulation of subcutaneous fat hard skin , slow blood flow Capillary permeability blood vulume edema shock DIC Systemic organic injury Prevention more important than treatment. 1. neonatal nursing. 2. pregnant women health care, avoid preterm labor, dystoxia, birth trauma and infection Clinical Manifestation onset within 1 we after birth, in cold season. 1. history: cold season, premature, anoxia, birth trauma, infection, lack of heat. 2. Symptoms: typical type—poor reaction, no suck no cry, unrised body temperature, sclenema. 3.1 sclenema: hard skin, edema, cold, dark red; order: leg→upper extremities 3.2 hypothermia: often35℃, severe case30℃ 3.3 multi-organic dysfunction: diminished heart sound, slow HR,microcirculation dysfunction; serious case: shock, DIC, renal failure, pneumorrhagia. 3.4 Complicated infection: e.g. pneumonia, sepsis. Graduation of Scleredema Neonatorum Grade Scleredema Axillary-rectal Organic Dysfunction area T Difference Mild 20%