- 期刊
Meconium Aspiration in Newborn Infants
新生兒胎便吸入症候羣
摘要
本篇報告是以前瞻式及回顧式的方法來收集病例。從1981年元月起至1983年6月止，在本院小兒加護病房中共有50例胎便吸入症候羣者。其中的16例是以前瞻式的方法收集的（從1983年1月1日至1983年6月30日）。這16個病例占有同時期內在本院出生的活產嬰兒的0.8%。在同一時期內，共有34例胎便吸入症候羣者是以回顧式的方法收集的，他們之中有的是在本院出生，有的則由別的醫院或由助產士轉來本院接受治療的。在這50例病兒中，皆在產後不久即發生種種呼吸窘迫的現象（如：呼吸急促，胸骨凹陷，鼻翼擴張，發紺等等）。在這50個病例之中，10例發生了氣胸或合併有氣胸中膈，其或然率為20%，他們往往需要較長的呼吸治療。8例(16%)併發了持續性肺動脈高壓症，使得病情惡化並大大地提高了死亡率。在本文中，我們擬定了一份對於這些高危險嬰兒的急救步驟，並強調氣管內抽取的重要性。我們相信大多數的胎便吸入症候羣是可以預防的。然而這須經由種種積極的處置，如：產中胎心音的監視，胎兒頭部採血，產後立即吸取口、鼻以及氣管內的胎便，適時地抽出胃液，並供給氧氣以及給予其他適當的急救處置等等。
關鍵字
無資料並列摘要
From January 1983 to June 1983, 378 cases (20.2%) of the 1975 live-birth newborn infants were found to be born in Changhua Christian Hospital with meconiumstained amniotic fluid on a prospective basis. At birth, intensive resuscitation methods including oxygen inhalation, suction of the hypopharynx and trachea were applied immediatedly in the delivery room to prevent meconium aspiration. Sixteen of these high risk newborns developed meconium aspiration syndrome (MAS). During Jan. 1981 to Dec. 1982, another 34 newborn infants were diagnosed to have MAS presenting various types of respiratory problems. Ten (20%) of the 50 MAS Patients developed pneumothorax with or without pneumomediastium, and needed a longer period of respiratory therapy. Eight (16%) of them had pulmonary hypertension resulting in a higher mortality rate. Treatment with antibiotics was given to every infant, but steroids were not used.