胎粪吸入综合征

最后审阅: 6 六月 2022
最后更新: 29 三月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 过期产体征
  • 呼吸急促
  • 发绀
  • 收缩期杂音
  • 胸壁不对称伴气流减少
  • 桶状胸
更多 关键诊断因素

其他诊断因素

  • 呻吟
  • 吸凹
  • 啰音
  • 干啰音
  • 心动过速
  • 低血压
其他诊断因素

危险因素

  • 孕周>42 周
  • pregnancy-induced hypertension
  • maternal diabetes mellitus
  • maternal smoking or substance misuse
  • 胎儿窘迫
  • 羊水过少
  • 大量胎粪
  • 阿普伽评分<7
  • 绒毛膜羊膜炎
  • 剖宫产
  • black ancestry
  • 男性
更多 危险因素

诊断性检查

首要检查

  • 胸部 X 线检查 (CXR)
  • 全血细胞计数 (FBC)
  • C 反应蛋白 (CRP)
  • 血液培养
更多 首要检查

需考虑的检查

  • 双侧脉搏氧饱和度
  • ABG(pH、PaO₂、PaCO₂)
  • 超声心动图
  • 头颅超声
  • 脑电图检查
  • 尿液分析
更多 需考虑的检查

治疗流程

急症处理

vigorous infant born through meconium-stained amniotic fluid, no respiratory distress

轻度 MAS

中度 MAS

重度 MAS

撰稿人

作者

Dharmapuri Vidyasagar, MD, MSc, FAAP, FCCM, PhD (Hon)
Dharmapuri Vidyasagar

Professor Emeritus

Department of Pediatrics

University of Illinois at Chicago

Chicago

IL

Visiting Professor

Department of Neonatology

Sri Ramachandra Medical College

Chennai

India

利益声明

DV is an author of a number of references cited in this topic. He has received royalties for editing the following books: Neonatal Ventilation (Elsevier India), Practical Neonatology (Indian Journal of Pediatrics), and Perinatal Cardiology (Cambridge Scholar publishing).

Rama Bhat, MD, FAAP

Professor of Pediatrics

Department of Pediatrics

University of Illinois at Chicago

Chicago

IL

利益声明

RB is an author of a reference cited in this topic.

同行评议者

James Wynn, MD

Medical Instructor

Department of Pediatrics

Division of Neonatology

Duke University

Durham

NC

利益声明

JW declares that he has no competing interests.

Henry L. Halliday, MD, FRCPE, FRCP, FRCPCH

Professor

Retired Consultant Neonatologist

Royal Maternity Hospital

Honorary Professor

Department of Child Health

Queen's University Belfast

Belfast

UK

利益声明

HLH declares that he has no competing interests.

John Sinn, MBBS(Syd), Dip Paed, DCH, MMed (Clin Epi), FRACP (Paed)

Clinical Senior Lecturer

Obstetrics

Gynaecology and Neonatology

Royal North Shore Hospital and The University of Sydney

Sydney

Australia

利益声明

JS declares that he has no competing interests.

  • 胎粪吸入综合征 images
  • 鉴别诊断

    • 新生儿暂时性呼吸急促
    • 肺表面活性物质不足
    • 持续性肺动脉高压
    更多 鉴别诊断
  • 指南

    • Neonatal resuscitation: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 5
    • 出生时的胎粪管理指南
    更多 指南
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