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6/27/2024 新生儿黄疸新生儿黄疸 Neonatal Jaundice8/11/2023 新生儿黄疸 16/27/2024Neonatal jaundiceNeonatal jaundice 目的要求目的要求了解新生儿胆红素代谢的特点了解新生儿胆红素代谢的特点掌握掌握生理性黄疸(生理性黄疸(physiologic physiologic jaundice jaundice 及及病理性黄疸(病理性黄疸(pathologic pathologic jaundicejaundice)的特点的特点 熟悉新生儿溶血病的临床表现熟悉新生儿溶血病的临床表现掌握新生儿溶血病的护理掌握新生儿溶血病的护理8/11/2023Neonatal jaundice 26/27/2024Neonatal JaundiceNeonatal Jaundice 新生儿胆红素代谢的特点新生儿胆红素代谢的特点 Neonate can produce more Neonate can produce more quantities of bilirubinquantities of bilirubin(胆红素)(胆红素).Deficient ability of transporting Deficient ability of transporting bilirubin.bilirubin.Deficient liver function.Deficient liver function.Enterohepatic circulation Enterohepatic circulation(肠肝循(肠肝循环)环)is specialis special8/11/2023Neonatal Jaundice 36/27/2024Neonatal jaundiceNeonatal jaundice 生理性黄疸(生理性黄疸(physiologic physiologic jaundicejaundice)的特点的特点 出现黄疸的时间出现黄疸的时间:黄疸持续的时间黄疸持续的时间:8/11/2023Neonatal jaundice 生46/27/2024Neonatal JaundiceNeonatal Jaundice 新生儿生理性黄疸(新生儿生理性黄疸(physiologic physiologic jaundicejaundice)的特点的特点 黄疸的程度黄疸的程度:黄疸的进展黄疸的进展:一般情况良好一般情况良好 8/11/2023Neonatal Jaundice 56/27/2024Neonatal jaundiceNeonatal jaundice 新生儿病理性黄疸(新生儿病理性黄疸(pathologic pathologic jaundice jaundice)的特点)的特点 occurrence occurrence tootoo earlyearly (过早)(过早)degree degree tootoo severesevere(过重)(过重)progress progress tootoo rapidrapid(过快)(过快)duration duration tootoo longlong (过长)(过长)again occurrenceagain occurrence(退而复现)(退而复现)after subsidisedafter subsidised 8/11/2023Neonatal jaundice 66/27/2024Neonatal jaundiceNeonatal jaundice 引起新生儿病理性黄疸的几种常引起新生儿病理性黄疸的几种常见见 病因病因 hemolytic disease of the hemolytic disease of the newborn newborn(新(新 生儿溶血病)生儿溶血病)neonatal septicemianeonatal septicemia(新生儿(新生儿败血症)败血症)neonatal hepatitisneonatal hepatitis(新生儿肝(新生儿肝炎)炎)congenital atresia of the congenital atresia of the bile ductsbile ducts (先天性胆道闭锁)(先天性胆道闭锁)8/11/2023Neonatal jaundice 76/27/2024 新生儿溶血病新生儿溶血病 Hemolytic DiseaseHemolytic Disease of the Newborn of the Newborn8/11/2023 新生儿溶血病 He8THANK YOUSUCCESS2024/6/279可编辑THANK YOUSUCCESS2023/8/1196/27/2024EtiologyEtiology(病因)(病因)and and pathogenesis pathogenesis(发(发病机制)病机制)ABOABO血型不合溶血病血型不合溶血病 最常见的母婴血型:母亲最常见的母婴血型:母亲“O”O”型;婴型;婴 儿儿“A”A”或或“B”B”型。型。8/11/2023Etiology(病因)and 106/27/2024 RhRh溶血病中以溶血病中以RhDRhD溶血病最常见,溶血病最常见,其次为其次为RhERhE溶血病。溶血病。R Rh血型不合溶血病血型不合溶血病8/11/2023 Rh血型不合溶血病116/27/2024Clinical manifestationClinical manifestation(临床表现)(临床表现)jaundice(jaundice(黄疸黄疸)anemia anemia(贫血)(贫血)hepatosplenomegalyhepatosplenomegaly(肝脾大)(肝脾大)8/11/2023Clinical manifestatio126/27/2024ComplicationComplication(并发症)(并发症)bilirubin encephalopathy(bilirubin encephalopathy(胆红素脑胆红素脑病病)kernicteruskernicterus(核黄疸)(核黄疸)8/11/2023Complication(并发症)136/27/2024 Laboratory testLaboratory testl l检查母婴血型(检查母婴血型(ABO and Rh blood typeABO and Rh blood type)l l溶血的证据:血色素下降、网织红细胞及有核红细溶血的证据:血色素下降、网织红细胞及有核红细胞增高。胞增高。l l血清特异性抗体检查血清特异性抗体检查 红细胞直接抗人球蛋白试验红细胞直接抗人球蛋白试验 抗体释放试验抗体释放试验 血清游离抗体血清游离抗体 8/11/2023 Laboratory te146/27/2024TreatmentTreatment(治疗)(治疗)治疗原则治疗原则 产前监测和处理。产前监测和处理。产后新生儿治疗。产后新生儿治疗。8/11/2023Treatment(治疗)156/27/2024 Nursing Nursing 护理评估护理评估 护理诊断护理诊断 PC:PC:胆红素脑病、心衰胆红素脑病、心衰 Knowledge deficitKnowledge deficit8/11/2023 Nursing 166/27/2024 Nursing Nursing 护理措施护理措施 密切观察病情,预防胆红素脑病密切观察病情,预防胆红素脑病 做好光疗和换血治疗的准备与护理做好光疗和换血治疗的准备与护理 准确无误执行医嘱,密切观察疗效准确无误执行医嘱,密切观察疗效 减轻心脑负担,防止心衰减轻心脑负担,防止心衰 健康教育健康教育8/11/2023 Nursing 17p经常不断地学习,你就什么都知道。你知道得越多,你就越有力量pStudyConstantly,AndYouWillKnowEverything.TheMoreYouKnow,TheMorePowerfulYouWillBe写在最后经常不断地学习,你就什么都知道。你知道得越多,你就越有力量写18Thank You在别人的演说中思考,在自己的故事里成长Thinking In Other PeopleS Speeches,Growing Up In Your Own Story讲师:XXXXXX XX年XX月XX日Thank You19
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