儿科
词汇介绍
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解析
neonatal 英 /,niːə(ʊ)'neɪt(ə)l/ 美 /,nio'netl/
释 义 adj. 新生的；初生的
例 句 Neonatal neurons can migrate into the areas of the infarction, substituting some dead neurons. 新生的神经元还可以迁移到病灶区替代一部分死亡的神经元。
apnea 英 /æp'nɪə/ 美 /æp'niə/
释 义 n. [医] 窒息，[临床] 呼吸暂停
例 句 For example, patients with hypertension, high blood pressure and some patients are at night or during the morning high blood pressure because blood pressure at night of sleep apnea causes the disease. 比如说高血压病人，有的病人都是夜里血压高，或者早晨起来时血压高，这是因为夜里睡眠呼吸暂停引起血压病的原因。
概述
概述
新生儿呼吸暂停即为新生儿在一段时间之内无呼吸运动，其在早产儿人群中属于较为常见的一种疾病。新生儿呼吸暂停属于新生儿科当中较为常见的一种危重症，其可对新生儿的机体产生极大的危害，且可严重威胁新生儿的生存质量甚至生命安全。
病因及临床意义
目前临床将新生儿呼吸暂停分为原发性与继发性两种，其中原发性呼吸暂停即为新生儿在未有任何原发因素的基础上出现呼吸暂停症状，该症状的发生同新生儿的胎龄及出生体重有密切关联。继发性呼吸暂停即为受各种不同基础疾病影响出 现的呼吸暂停症状，中枢系统结构与功能不成熟、低氧血症、低血钙等均与疾病发生有密切关联。目前相关学者指出，新生儿呼吸暂停可能同内啡肽物质存在关联，在中枢神经系统当中，内啡肽有神经内分泌和神经递质的作用存在，其可以将脑干对于二氧化碳的敏感度降低，对通气功能进行抑制，进而将体内维持氧交换生理平衡机制减弱。除此之外，内啡肽可导致心率减缓、呼吸暂停及呼吸减弱等症状，诱发低氧血症，而高碳酸血症可对内啡肽的释放产生刺激作用，其可导致大量内啡肽进入至血浆当中，其为早产儿发生原发性呼吸暂停的病理生理基础。相关研究指出，早产儿原发性呼吸暂停患儿的血浆当中，β-内啡肽水平明显较高，其在早产儿呼吸暂停的发病当中有重要作用，亦为导致疾病发生与复发的一项重要性因素。
症状表现
患儿可出现呼吸停止，且部分患儿常有心跳缓慢、肌肉张力下降及肤色苍白或青紫等表现。
诊断方法
依据临床表现即可诊断：患儿可出现15~20s呼吸停止的表现，且部分患儿常有心跳缓慢、肌肉张力下降及肤色苍白或青紫等表现存在。
治疗方法
枸橼酸咖啡因应用于新生儿呼吸暂停治疗中可获得理想的临床效果，而大剂量用药可在短时间内促进患儿疾病症状的改善，值得今后临床广泛应用。对继发性呼吸暂停患儿积极寻找并治疗其原发病，积极控制感染，及时纠正水电解质平衡紊乱，如及时纠正酸中毒、低血糖、低血钠、低血钙等情况。
复制标题坏死性小肠结肠炎和自发性肠穿孔早产儿咖啡因暴露与急性肾损伤
发表时间：2018-11-06
影响指数：2.8
作者： Noelia Aviles-Otero
期刊：Pediatr Nephrol
Fifth, our study simultaneously evaluated patients with both NEC and SIP. This limits the ability to determine the role of AKI in each disease process specifically. While NEC and SIP are pathologically distinct conditions, in clinical practice, it may be difficult to distinguish between them with certainty using current classification schema. Moreover, we feel that both of these conditions provide a suitable pathophysiologic model for AKI. Finally, this study considered only patients with NEC/SIP; healthy controls were not included. It cannot be determined from this study whether exposure to caffeine might increase the likelihood of developing NEC or SIP, or alter the natural history of either disease when it occurs. Some small studies have suggested a direct association between caffeine exposure and NEC and an inverse relationship with SIP. However, large randomized controlled trials found no difference in the occurrence of these conditions among patients receiving caffeine versus placebo. Exposure to caffeine in preterm infants with NEC or SIP is associated with decreased incidence and severity of AKI. These data are consistent with other recent studies in the general NICU population and suggest potential utility of caffeine in preventing AKI. Further studies are needed to delineate optimal timing and dosing of caffeine to maximize its benefits.
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