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
其他诊断因素
- 呻吟
- 吸凹
- 啰音
- 干啰音
- 心动过速
- 低血压
危险因素
- 孕周＞42 周
- 妊娠高血压综合征
- 妊娠糖尿病
- 母亲吸烟或物质滥用
- 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
- 黑人血统
- 男性
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)
- 血培养
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
治疗流程
婴儿出生时存在羊水胎粪污染，有活力，无呼吸窘迫
轻度 MAS
中度 MAS
重度 MAS
撰稿人
作者
Dharmapuri Vidyasagar, MD, MSc, FAAP, FCCM, PhD (Hon)
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.
鉴别诊断
- 新生儿暂时性呼吸增快症
- 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
- 新生儿复苏：2020 年美国心脏协会新生儿心肺复苏和心血管急救技术指南，第 5 部分
- 出生时的胎粪管理指南
更多 指南
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