新生儿青紫129例病因及临床特征分析  

Analysis of the Etiologies and Clinical Characteristics of 129 Cases of Neonatal Cyanosis

作　　者：姜赤秋 吴兆芳 吴晓丰 

机构地区：[1]湖北省中山医院新生儿科,湖北省武汉市430033

出　　处：《医学理论与实践》2010年第3期268-271,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨新生儿青紫的病因和临床特征。方法:回顾性分析湖北省中山医院新生儿重症监护室2007年1月-2008年12月病因明确的129例青紫患儿的临床资料。结果:(1)129例青紫新生儿中,中心性青紫101例(78.3%),其中以原发肺部疾病为首要病因,即肺源性青紫92例(71.3%),心源性青紫仅9例(7%);周围性青紫13例(10.1%);其他原因青紫15例(11.6%)。(2)129例青紫新生儿入院时连续监测经皮血氧饱和度(continuous trans-cutaneous oxygen saturation,TcSO2)并完善相关检查,根据病情给予不同方式的氧疗。氧疗前101例中心性青紫患儿TcSO2均低于85%,氧疗后76例肺源性青紫消失,TcSO2升至85%以上,余25例皮肤青紫未消失,TcSO2仍低于85%;氧疗效果不佳的25例中心性青紫新生儿中,13例为肺部疾患合并持续胎儿循环,9例为复合型先心病,3例为先天性膈肌发育异常。氧疗前13例周围性青紫患儿TcSO2均大于85%,8例氧疗后青紫略有减轻,5例为局部挤压伤停用氧疗。在15例其他原因青紫患儿中,氧疗对青紫发作现象无改善作用。结论:新生儿青紫的病因以原发肺部疾病为首位。氧疗是青紫治疗的基本方法,但氧疗的效果因病因的不同而有明显的差异。Objective：To explore the etiologies and clinical characteristics of neonatal cyanosis. Methods： The clinical data of 129 cases of cyanotic neonates from Jan 2007 to Dec 2008 in hospital were analyzed retrospectively. Results： （1） Of 129 cases of cyanotic neonates, primary pulmonary diseases were the most common cause of cyanosis. There were 101 cases （78.3%） of central cyanosis, among which 92 cases （71. 3%） were pulmonary cyanosis and only 9 cases （7.0%） were cardiac cyanosis; 13 eases （10. 1%） were peripheral cyanosim 15 eases （11.6%） were other cyanosis. （2） TeSO2 monitoring and relevant examination were performed in 129 cases of cyanotic neonates at once after admission. Different patterns of oxygen therapy were given according to patient＇s condition. Before oxygen therapy,TcSO2 in 101 cases of central cyanotic neonates was all＇below 85%. Of these 101 eases, after oxygen therapy 76 cases of pulmonary cyanosis disappeared and TcSO2 was above 85% while the other 25 cases of cyanosis didn＇t disappear and TcSO2 was still below 85%; Among 25 cases of central cyanotic neonates whose oxygen therapy didn＇t yield good results, 13 cases were ill with pulmonary diseases accompanied with persistent fetal circulation, 9 cases were ill with compound congenital heart diseases and 3 cases with congenital developmental anomaly of diaphragma. Before oxygen therapy,TcSO2 in 13 cases of peripheral cyanotic neonates was all above 85%. Of these 13 cases, 8 cases of cyanosis were slightly alleviated after oxygen !herapY and 5 cases diagnosed bruising were called off oxygen therapy. Of 15 cases of other cyanotic neonates, eyanosis didn＇t acquire improvement after oxygen therapy. Conclusion： Primary pulmonary diseases are the most common cause of neonatal cyanosis. Oxygen therapy is basic lreatment method of cyanosis, but its results may have obvious difference because of different cyanotic cause.

关 键 词：青紫 病因 氧疗 新生儿 

分 类 号：R722.1[医药卫生—儿科]