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新生儿溶血病患儿的心肺状况:III. 出生后最初几小时内的血管内压力。

Cardiorespiratory status of erythroblastotic newborn infants: III. Intravascular pressures during the first hours of life.

作者信息

Phibbs R H, Johnson P, Kitterman J A, Gregory G A, Tooley W H, Schlueter M

出版信息

Pediatrics. 1976 Oct;58(4):484-93.

PMID:987574
Abstract

We measured aortic and central venous pressures beginning soon after birth in 40 prematurely born infants with moderate or severe erythroblastosis fetalis, including 13 with severe and 10 with mild hydrops fetalis. All but four were asphyxiated at birth and this affected intravascular pressures. Before resuscitation, aortic or central venous pressure or both were elevated in more than one third. All but two of the remaining infants had normal initial pressures. Following resuscitation which relieved acidosis, hypoxia, and anemia, but did not reduce blood acidosis, hypoxia, and anemia, but did not reduce blood volume, the high pressures usually fell to normal and occasionally to subnormal levels, normal pressures fell to subnormal in almost one half, and those with initial subnormal pressures remained hypotensive. In all, 40% were hypotensive after resuscitation; treatment with blood volume expanders consistently returned these pressures to normal. Only two of the 13 severely hydropic infants and none of the mildly hydropic had findings indicative of hypervolemia and myocardial failure which persisted after treatment of asphyxia.

摘要

我们对40例患有中度或重度胎儿成红细胞增多症的早产婴儿出生后不久就开始测量主动脉压和中心静脉压,其中包括13例重度胎儿水肿和10例轻度胎儿水肿的婴儿。除4例外,所有婴儿出生时均有窒息,这影响了血管内压力。复苏前,超过三分之一的婴儿主动脉压或中心静脉压或两者均升高。其余婴儿中除2例外,初始压力均正常。复苏缓解了酸中毒、缺氧和贫血,但未减少血容量,高压通常降至正常,偶尔降至低于正常水平,正常压力几乎有一半降至低于正常水平,初始压力低于正常的婴儿仍为低血压。总之,40%的婴儿复苏后为低血压;使用血容量扩充剂治疗可使这些压力持续恢复正常。13例重度水肿婴儿中只有2例,轻度水肿婴儿中无一例有提示血容量过多和心肌衰竭的表现,这些表现在窒息治疗后持续存在。

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