新生儿休克ppt课件.pptx

1、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller

2、and DS18B20 temperature sensor.新生儿休克新生儿休克广州医科大学附属第一医院广州医科大学附属第一医院 儿科儿科湛洁谊湛洁谊This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip m

3、icrocomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.新生儿休克新生儿休克休克是各种原因导致有效循环血量减少，休克是各种原因导致有效循环血量减少，引起重要器官的微循环灌流量不足，导引起重要器官的微循环灌流量不足，导致全身脏器功能不全的临床综合征。致全身脏器功能不全的临床综合征。This paper mainly introduces the design of an intelligent temperature control sys

4、tem which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.发病机制 心输出减少心输出减少 全身血管阻力减少全身血管阻力减少This paper mainly

5、introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temper

6、ature sensor.新生儿休克分类 低血容量休克：循环血量不足，导致低血容量休克：循环血量不足，导致CO减少减少 分布性休克：液体从血管内向血管外间歇的分布性休克：液体从血管内向血管外间歇的异常分布，导致异常分布，导致SVR严重降低严重降低 心源性休克：心肌功能障碍引起心源性休克：心肌功能障碍引起 阻塞性休克：流出道阻塞或流入道阻塞阻塞性休克：流出道阻塞或流入道阻塞This paper mainly introduces the design of an intelligent temperature control system which realizes the function

7、of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.休克基本表现 皮肤苍白皮肤苍白、肢端发绀肢端发绀 肢端发凉：上肢达肘部，下肢达膝部肢端发凉：上肢达肘部，下肢达膝部 毛细血管再充盈时间延长：足跟部毛细血管再充盈时间

8、延长：足跟部5秒，前臂秒，前臂3秒秒 心率改变：心率改变： 160次次/分，或分，或100次次/分分 精神萎靡，精神萎靡，先激惹后抑制先激惹后抑制 股动脉搏动减弱股动脉搏动减弱 低血压：足月低血压：足月50mmHg，早产儿，早产儿40mmHg， 极极早早产儿早早产儿30mmHg 尿量减少：尿量减少： 81苍白苍白较慢较慢发凉发凉减弱减弱682花纹花纹甚慢甚慢发冷发冷触不到触不到6注：皮肤循环：指压前臂内侧皮肤毛细血管再充盈时间，正常4秒四肢温度：发凉为凉至肘膝关节以下；发冷为凉至肘膝关节以上新生儿休克评分：轻度为5分，中度为68分，重度为910分摘自：吴玉斌，韩玉昆.新生儿休克诊断标准探讨.中

9、国实用儿科杂志,1997,12:86-87This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT8

10、9C51 microcontroller and DS18B20 temperature sensor.辅助检查 血乳酸血乳酸 血气分析血气分析 血糖血糖 血电解质、肾功能血电解质、肾功能 凝血功能凝血功能 炎症指标：血常规、炎症指标：血常规、CRP、PCT、血培养、血培养 超声检查超声检查 胸胸片片 心电图心电图 中心静脉压（中心静脉压（58mmHg）This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temper

11、ature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.休克诊断 是否存在休克是否存在休克 休克严重程度休克严重程度 病因病因 休克类型休克类型 评价脏器功能损害评价脏器功能损害This paper mainly introduces t

12、he design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor

13、.新生儿休克治疗 病因治疗病因治疗 扩容扩容 纠酸纠酸 血管活性血管活性药物药物 呼吸支持：呼吸窘迫、呼吸暂停、肺出血呼吸支持：呼吸窘迫、呼吸暂停、肺出血 纠正心功能不全纠正心功能不全 防治防治DIC：早期使用肝素：早期使用肝素 糖皮质激素：氢化可的松、甲强龙糖皮质激素：氢化可的松、甲强龙 纳洛酮纳洛酮 对症支持对症支持This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement

14、 and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.扩容 NS20ml/kg，510分钟，分钟，1小时可达小时可达4060ml/kg 继续维持液可选择继续维持液可选择1/22/3张液体，张液体，24ml/kg.h CVP58mmHg 液体负荷过多可利尿液体负荷过多可利

15、尿 胶体液问题胶体液问题 血糖问题血糖问题This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT8

16、9C51 microcontroller and DS18B20 temperature sensor.血管活性药物 纠正血容量和酸中毒基础上纠正血容量和酸中毒基础上 多巴胺：多巴胺：515g/kg.min 肾上腺素：肾上腺素：0.051g/kg.min 多巴酚丁胺：多巴酚丁胺：515g/kg.min 异丙肾上腺素：异丙肾上腺素：0.052g/kg.min，心率慢伴传，心率慢伴传导阻滞导阻滞This paper mainly introduces the design of an intelligent temperature control system which realizes the

17、 function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.注意事项 新生儿出现休克、肝大、发绀、新生儿出现休克、肝大、发绀、心脏杂音心脏杂音或上下或上下肢血压或脉搏有肢血压或脉搏有差异，差异，应立即予应

18、立即予前列腺素前列腺素E，直直到心脏超声排除复杂到心脏超声排除复杂先天性心脏病先天性心脏病 高氨血高氨血症或症或低血糖导致的先天性代谢缺陷如可类低血糖导致的先天性代谢缺陷如可类似感染性休克似感染性休克表现表现，需做适当的实验室检查排除，需做适当的实验室检查排除这些情况这些情况。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using

19、single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.注意事项 如果儿茶酚胺类药物外周如果儿茶酚胺类药物外周渗透渗透，其不良反应可能，其不良反应可能会被酚妥拉明会被酚妥拉明(15 mg溶于溶于5 mL生理盐水生理盐水)局部局部皮下浸润皮下浸润(注射注射)所所抵销抵销 使用使用肾上腺素患者血浆肾上腺素患者血浆乳酸水

20、平乳酸水平升高升高 心血管药物的选择及其剂量根据器官灌注的需要心血管药物的选择及其剂量根据器官灌注的需要会随时发生会随时发生变化，同样重要的是识别变化，同样重要的是识别血管活性药血管活性药物的特征及不同作用物的特征及不同作用。 增强心脏收缩力和降低增强心脏收缩力和降低SVR另一个选择是应用另一个选择是应用型磷酸二酯酶型磷酸二酯酶抑制剂抑制剂(PDEls)，这类药物包括米力，这类药物包括米力农和氨农和氨力力农农（低排高阻）（低排高阻）This paper mainly introduces the design of an intelligent temperature control syst

21、em which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introduces the design of an intel

22、ligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer. The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.评分皮肤颜色皮肤循环四肢温度股动脉搏动 血压（kPa）0正常正常正常正常81苍白较慢发凉减弱682花纹甚慢发冷触不到6注：皮肤循环：指压前臂内侧皮肤毛细血管再充盈时间，正常4秒四肢温度：发凉为凉至肘膝关节以下；发冷为凉至肘膝关节以上新生儿休克评分：轻度为5分，中度为68分，重度为910分摘自：吴玉斌，韩玉昆.新生儿休克诊断标准探讨.中国实用儿科杂志,1997,12:86-87