Department of Surgery, Mercer University School of Medicine, Medical Center of Central Georgia, 777 Hemlock St., MSC 140, Macon, GA 31201, USA.
J Pediatr Urol. 2010 Jun;6(3):232-8. doi: 10.1016/j.jpurol.2010.03.009.
The unique physiological changes that occur at birth and the adaptations that come in the first weeks of life profoundly affect the clinical management of the surgical newborn patient. The newborn has adaptive challenges that have to be met at birth: (a) establish a functional residual capacity and breathe; (b) change from a fetal to a newborn circulatory circuit; (c) change from fetal hemoglobin to hemoglobin A; (d) sustain a heart rate dependent cardiac output; (e) maintain normal body temperature; establish renal function and regulate postnatal body fluid composition; (f) establish hepatic function; and (g) maintain normal vital signs. Classical physiological studies of the last century describe the physiological basis of these adaptive tasks, and support practical considerations that we follow in clinical practice.
出生时发生的独特生理变化和生命最初几周的适应过程，深刻地影响了外科新生儿患者的临床管理。新生儿在出生时面临适应挑战，需要应对以下几个方面：(a)建立功能性残气量并进行呼吸；(b)从胎儿循环系统转变为新生儿循环系统；(c)从胎儿血红蛋白转变为血红蛋白 A；(d)维持依赖心率的心输出量；(e)维持正常体温；建立肾功能并调节产后体液成分；(f)建立肝功能；(g)维持正常生命体征。上世纪的经典生理学研究描述了这些适应任务的生理基础，并为我们在临床实践中遵循的实际考虑提供了支持。
