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11.
肺表面活性物质治疗新生儿胎粪吸入综合征的临床研究 总被引:4,自引:0,他引:4
目的探讨肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的有效性及临床价值。方法采用气管内滴入PS治疗8例MAS患儿,其中6例接受PS2剂,2例接受PS3剂。结果给予首剂PS后10分钟患儿青紫迅速消失,皮肤转红润,经皮测定血氧饱和度(TcSaO2)升高。30分钟后患儿低氧血症迅速改善,动脉血氧分压、动脉血氧分压与吸入氧浓度比值、动脉肺泡血氧分压比值、呼吸机有效指数较治疗前显著增高,分别由原来的528±098kPa、866±352kPa、012±006kPa及014±006ml·kPa-1·kg-1增加到891±143kPa、1681±418kPa、021±005kPa及026±007ml·kPa-1·kg-1;而吸入氧浓度及平均气道压逐渐降低,由原来的068±019kPa及220±042kPa降低到053±008kPa及193±048kPa。重复应用PS后亦有相似效果。结论PS能有效地改善MAS患儿肺顺应性及氧合功能。重复应用PS可巩固和加强疗效。 相似文献
12.
早期腭裂修复术后瘘的发生率研究 总被引:5,自引:0,他引:5
目的 探讨婴儿期腭裂手术后瘘发生的规律。方法 对1995年7月~2001年9月期间施行的2~12个月龄的531例腭裂修复术后瘘发生率进行回顾性分析。结果 全组腭裂术后瘘发生率为4.9%,双侧完全性腭裂术后瘘发生率(7.8%),明显高于不完全性腭裂(4.4%),单侧完全性腭裂(4.3%,P<0.01),后两组之间无显著性差别(P>0.05);术后瘘发生率与年龄,及本组所采用的不同术式无关(P>0.05);其中硬腭部瘘占完全性腭裂术后瘘率70%,较其它部位差异有非常显著性意义(P<0.01)。结论 婴儿期腭裂手术并不会增加瘘发生率,对于双侧完全性腭裂,推荐做术前正畸治疗。 相似文献
13.
Stephanie Moriceau Tania L. Roth Terri Okotoghaide Regina M. Sullivan 《International journal of developmental neuroscience》2004,22(5-6):415-422
In many altricial species, fear responses such as freezing do not emerge until sometime later in development. In infant rats, fear to natural predator odors emerges around postnatal day (PN) 10 when infant rats begin walking. The behavioral emergence of fear is correlated with two physiological events: functional emergence of the amygdala and increasing corticosterone (CORT) levels. Here, we hypothesize that increasing corticosterone levels influence amygdala activity to permit the emergence of fear expression. We assessed the relationship between fear expression (immobility similar to freezing), amygdala function (c-fos) and the level of corticosterone in pups in response to presentation of novel male odor (predator), littermate odor and no odor. CORT levels were increased in PN8 pups (no fear, normally low CORT) by exogenous CORT (3 mg/kg) and decreased in PN12 pups (express fear, CORT levels higher) through adrenalectomy and CORT replacement. Results showed that PN8 expression of fear to a predator odor and basolateral/lateral amygdala activity could be prematurely evoked with exogenous CORT, while adrenalectomy in PN12 pups prevented both fear expression and amygdala activation. These results suggest that low neonatal CORT level serves to protect pups from responding to fear inducing stimuli and attenuate amygdala activation. This suggests that alteration of the neonatal CORT system by environmental insults such as alcohol, stress and illegal drugs, may also alter the neonatal fear system and its underlying neural control. 相似文献
14.
Liana Beni-Adani Naresh Biani Liat Ben-Sirah Shlomi Constantini 《Child's nervous system》2006,22(12):1543-1563
Background and objective The classification of hydrocephalus in newborns and in infants is different from the classification in adulthood. This difference
exists due to disparity in the source pathologies that produce the hydrocephalus, and the practical distinctions in prognosis
and treatment choices. The objective of this paper is to present the spectrum of obstructive-communicating hydrocephalus,
which is more complex in the pediatric group, and to propose the relevance of this particular classification to treatment
options.
Materials and methods The authors categorized infants with active hydrocephalus at time of presentation into the following four groups along the
spectrum of communicating vs obstructive HCP. Group 1: patients with a purely absorptive (communicating) HCP. In these patients,
tetraventricular dilatation is usually observed with occasional extraaxial fluid accumulation. An extracranial CSF diversion
(shunt) is the treatment of choice. Group 2: patients with an obstructive component together with a persistent absorptive
component. In these patients, a technically successful endoscopic procedure will not prevent progression of clinical symptoms
of HCP. An extracranial CSF diversion (shunt) should be the treatment of choice even though some of these patients are currently
treated by endoscopy. Group 3: patients with an obstructive component together with a temporary absorptive component. In these
patients, a technically successful ETV should be followed by temporary CSF drainage [via LP, continuous spinal drainage (CLD),
or ventriculostomy] with or without supplemental medical treatment (i.e., Diamox) for several days. Such temporary drainage
may decrease failure rate in this subgroup. Group 4: patients with a purely obstructive HCP. In these patients, an endoscopic
procedure (ETV) is the treatment of choice. According to this spectrum classification, the authors classify different entities
with representative cases and discuss relevancy to treatment options and prognosis.
Results The data suggest that obstructive hydrocephalus in the very young population may be rather a combination of obstructive and
absorptive problem. The outcome of the patient depends mainly not only on the basic pathology causing the hydrocephalus but
also on the treatment that is chosen and its complications. While bleeding and infection represent the major causes for communicating
hydrocephalus, patients with complex pathologies of congenital type and intra- or interventricular obstructions may reflect
obstructive hydrocephalus. Treatment of these patients may be successful by shuntless procedures if the absorptive problem
is not the major component. In transient absorptive hydrocephalus, temporary measures were effective in many cases leading
to successful procedures of ETV and/or posterior-fossa decompression in selected cases.
Conclusions Shuntless procedures are the dream of a pediatric neurosurgeon provided it solves the problem and does not imply unacceptable
risk. However, the benefit has to be evaluated years after the procedure is performed, as only prospective multicenter studies
will truly show which procedure may have the best overall results in the developing child. Until such studies are available,
understanding the basic pathology or the combination of pathologies leading to hydrocephalus in a given child may open the
window of opportunities for other than shunt surgery in many hydrocephalic children with major obstructive component. 相似文献
15.
侧脑室注射东莨菪碱和酚妥拉明对幼兔分辨学习的影响 总被引:3,自引:1,他引:2
目的 探讨东莨菪碱和酚妥拉明对幼兔分辨学习的影响。方法 将30只比利时纯种幼兔从生后13日龄随机分为三组:东莨菪碱组、酚妥拉明组和生理盐水对照组,观察不同日龄各组幼兔的分辨学习能力。结果 幼兔分辨学习的正确反应一般始于生后15日龄。侧脑室注射东莨菪碱对16日龄以前幼兔分辨学习无明显影响,对17日龄以后幼兔分辨学习产生明显抑制作用。侧脑室注射酚妥拉明对13—23日龄幼兔分辨学习均有明显抑制作用。结论 幼兔生后发育过程中学习能力的发展具明显的阶段性,其原因可能与神经递质系统的发育成熟有关。 相似文献
16.
Many studies have shown that health conditions experienced in childhood play an important role on an individual's adult mortality. Recent research suggests that past reductions in early life exposure to infectious diseases have been a major contributor to the historical decline in old-age mortality. Drawing on French-Canadian data from cohorts born in the 17th and 18th centuries, we test whether a progressive deterioration in early life conditions (as revealed by an increasing infant mortality rate) translates into a decrease in survival prospects in late life. We use traditional demographic measures such as the age-specific probability of death, and a series of proportional hazard models to control for familial and environmental conditions. Results point toward little evidence of any early life effects. The trend of increasing infant mortality does not correlate with a general increase of mortality in older ages within the same cohorts. Period changes affecting survival at older ages (war, epidemics) as well as demographic and biological characteristics shared within families have a much larger role in old-age mortality than early life characteristics shared within the same cohorts. 相似文献
17.
阿奇霉素替代激素治疗婴幼儿喘息性支气管炎临床研究 总被引:6,自引:0,他引:6
目的评价阿奇霉素治疗婴幼儿喘息性支气管炎的疗效并探讨其作用机制。方法婴幼儿喘息性支气管炎60例,随机分为2组,各30例,A组用阿奇霉素治疗,B组用地塞米松治疗,分别观察3d后的临床疗效;2组均测定其外周血清IL-4,IFN-γ浓度变化,并与15例健康婴幼儿(对照组)血清IL-4,IFN-γ浓度对比。结果A组与B组临床总有效率差异无统计学意义;整个喘息性支气管炎组与正常对照组相比IFN-γ和IL-4值差异均有统计学意义,IFN-γ下降,IL-4升高;各组治疗前与治疗后相比差异均有统计学意义,A组治疗后血清IFN-γ浓度增高、IL-4浓度下降;B组治疗后血清IFN-γ浓度下降、IL-4浓度也下降,且2组IFN-γ/IL-4值均显著升高。结论阿奇霉素治疗婴幼儿喘息性支气管炎有较好的疗效,能与地塞米松有同样的调节TH1及TH2细胞因子使之趋于平衡,并且有更好的促进细胞免疫作用。 相似文献
18.
19.
Ming-Shian Tsai Wen-Hsi Lin Wen-Ming Hsu Hong-Shiee Lai Po-Huang Lee Wei-Jao Chen 《Journal of gastrointestinal surgery》2008,12(12):2191-2195
Background/aims Surgical resection of choledochal cysts (CC) has become standard treatment. However, surgery is not universally recommended
in early infancy and/or asymptomatic patients. In order to investigate the optimal timing of CC excision, we analyzed clinicopathological
data and surgical results from different age groups.
Material and methods This retrospective review included 107 patients (77 females, 30 males) who underwent CC resection at the National Taiwan University
Hospital between January 1988 and December 2005. Patient demographic, clinical, and surgical data were collected and analyzed.
Results The patients were divided into three groups according to age at the time of surgery: <1 year old (group I, n = 26), 1−16 years old (group II, n = 48), and >16 years old (group III, n = 33). About two thirds of the patients in group I had jaundice, while abdominal pain related to inflammation was the commonest
symptom in groups II and III. Group I suffered significantly fewer surgical complications and less severe liver fibrosis than
groups II or III.
Conclusion CC surgery in infancy and in asymptomatic patients is safe and may prevent the complications of this condition. The results
support a recommendation for early excision. 相似文献
20.
小儿腹腔镜下疝囊高位结扎术的麻醉处理 总被引:1,自引:1,他引:0
目的探讨小儿腹腔镜下疝囊高位结扎术的麻醉处理方法和安全性。方法本组80例腹腔镜下疝囊高位结扎术患儿,ASAⅠ~Ⅱ级,以气管全麻下行术式,入室后连续监测HR、MAP、SpO2、气道峰压(PIP)、PETCO2及体温,并分别记录术前、气腹后5min、气腹后10min、放气后10min的各项监测指标。结果所有患儿麻醉均满意,无一例出现麻醉意外、并发症,CO2气腹后10、20min HR、MAP、PETCO2、PIP显著升高(p<0.05,p<0.01),SpO2无显著变化,放气后10min各项指标与术前相比差异无显著意义。结论面对小儿特殊的解剖、生理和CO2气腹对生理产生的影响,做好术前准备,选择正确的麻醉方法和合适的麻醉药物,维持稳定的循环,小儿可安全实施腹腔镜疝囊高位结扎手术。 相似文献