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小儿缺氧急救知识
发布时间:2010-12-31 11:11     来源:君健网
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     呼吸困难表现为呼吸频率、节律、深度、吸气和呼气比例失调等异常状态。病人有一种迫切需要空气和喘不上来气的不适感。表情痛苦,呼吸费劲,上气不接下气,烦躁不安。呼吸困难常伴有不同程度缺氧,表现为口唇或口周青紫,甚至整个面色发青。健康人在剧烈运动或情绪高度紧张时,可出现暂时性呼吸困难,待情绪平定后,呼吸困难就会消失。呼吸困难是很多疾病的严重表现。如新生儿先天鼻后孔闭锁畸形,产伤所致颅内出血,重症肺炎,脓气胸,严重性心脏病,肾脏疾病,神经性疾病等,有时也可引起程度不同的呼吸困难,患儿如出现这种表现,说明病情已十分严重,要立即送医院抢救。
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    了解呼吸困难的种类,可识别引起呼吸困难的原因,以便进一步治疗。一般分3个类型:(1)吸气性呼吸困难:是外界的空气吸入时发生困难。患儿吸气时间明显延长,特别费劲。吸气动作深而长,且出现喉部发响,严重的吸气性呼吸困难可出现锁骨上窝部、颈前胸骨上窝、肋间隙和心口部向里凹陷(医学上叫做三凹征)。吸气性呼吸困难常发生于喉、气管、大支气管的炎症、水肿、肿瘤或异物等引起狭窄或梗阻时。(2)呼气性呼吸困难:患儿吸气时较顺利,呼气时气体排出发生障碍,也就是肺部排出气体发生困难。患儿呼气时间明显延长、费劲。呼气时缓慢,有明显“呼、呼”声音。呼气性呼吸困难多觅于支气管哮喘、肺气肿、支气管内膜结核等。(3)混合性呼吸困难:同时存在吸气性呼吸困难和呼气性呼吸困难。如小儿肺炎有广泛性病变、脓气胸。心肌炎和心包炎在婴幼儿时期也可见到呼吸困难。
呼吸困难常伴有全身缺氧。脑细胞对缺氧最为敏感,缺氧时脑细胞先受到影响。缺氧严重时可出现神志不清、烦躁、抽搐、脑子出现水肿,此时呼吸更加困难,缺氧更加严重,进而使脑水肿更为加剧,最后可因呼吸中枢受损而呼吸停止。父母看到小儿呼吸有困难时,说明孩子病情十分严重,应立即送往医院,吸氧气,并进行抢救。在途中应密切观察小儿呼吸情况,切不可怕受风把头蒙紧。我们曾碰到有的家长送患儿往医院途中因包裹太严,加重缺氧,呼吸停止死亡。
 
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