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目的对围术期新生儿治疗经验进行总结及分析,为临床安全合理处置提供参考。方法选取佛山市妇幼保健院新生儿科2009年1月—2012年12月收治的104例围术期新生儿为研究对象,采取回顾性分析的方式,对其在治疗过程当中的机械通气方案、术后镇痛、液体疗法、营养支持等各方面进行综合分析。结果手术一次成功87例(83.65%),需二次手术的17例(16.35%),并发症7例(6.73%);产后新生儿手术92例(88.46%),其中死亡6例(5.76%),术后放弃2例(1.92%);产时手术9例(8.65%),死亡1例(0.96%);胎儿手术3例(2.88%),2例存活,1例死亡(0.96%)。结论围生期手术患儿应以低压、低氧、可耐受高碳酸血症的呼吸机策略为指导进行机械通气,在治疗过程中吗啡镇痛最为有效,同时宜早期开奶、缩短静脉营养时间可促进肠道功能恢复。
Objective To summarize and analyze the experience of perinatal neonatal treatment and provide reference for clinical safety and rational disposal. Methods A total of 104 perinatal newborns admitted to Department of Neonatology, Maternal and Child Health Hospital of Foshan City from January 2009 to December 2012 were retrospectively analyzed. The mechanical ventilation protocol Post-analgesia, fluid therapy, nutritional support and other aspects of a comprehensive analysis. Results A total of 87 cases (83.65%) were successful in operation, 17 cases (16.35%) required secondary surgery and 7 cases (6.73%) were complications. Postpartum neonatal surgery was performed in 92 cases (88.46%), of which 6 died ), 2 cases (1.92%) were given up after operation, 9 cases (8.65%) were delivered during operation, 1 case (0.96%) died during operation, 3 cases (2.88%) were fetal surgery, 2 cases survived and 1 case died . Conclusions Perinatal surgery should be guided by low pressure, hypoxia and hypercapnia ventilator strategy. Mechanical ventilation is most effective during morphine analgesia. At the same time, it is advisable to start early milk and shorten the intravenous nutrition Time can promote intestinal function recovery.