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婴幼儿常见病预防与护理宜忌速查

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★宝宝得了病怎么办?如何预防?一查就知!
★帮助家长走出照料生病宝宝的误区,树立科学的养育观念。
★重视疾病预防,养出健康宝宝。

Content Description

《婴幼儿常见病预防与护理宜忌速查》是系列丛书中的一本,是一本针对0-3岁婴幼儿常见病预防及护理宜忌问题的速查百科全书,内容覆盖新生儿、婴儿、幼儿常见病的护理和预防。本书内容详实,知识科学严谨。目录以疾病名称呈现,读者只需要了解该病的关键词,就可以很快找到其相关的护理和预防宜忌内容。本书注重从细节入手,针对性、实用性强,语言简洁,是帮助爸爸妈妈们科学养儿、爱儿的百科全书。
Author Description

ibaby母婴项目组,致力于妊娠、分娩、育儿、早教的研究,由多名业内专家组成,为中国的妈妈和宝宝提供科学、前沿、全面、实用的养育知识。

Catalogue

第一篇 新生儿期常见病防护宜与忌
新生儿产伤
头皮血肿
胸锁乳突肌血肿
骨折
臂丛神经麻痹
面神经麻痹
白眼球上的出血点
新生儿呼吸系统疾病
新生儿肺炎
新生儿湿肺
喉喘鸣
新生儿消化系统疾病
呕吐
腹胀
食欲不佳
腹泻
便秘
新生儿血液系统疾病
新生儿溶血病
新生儿黄疸
新生儿红细胞增多症
新生儿贫血
新生儿中枢神经系统疾病
新生儿惊厥
缺血缺氧性脑病
颅内出血
化脓性脑膜炎
新生儿营养及代谢性疾病
新生儿佝偻病
新生儿低钙血症
晚期代谢性酸中毒
新生儿感染性疾病
新生儿脐炎
新生儿败血症
新生儿发热
淋球菌性结膜炎
新生儿皮肤病
新生儿脓疱疹
新生儿皮下坏疽
新生儿剥脱性皮炎
新生儿其他疾病
新生儿鹅口疮
新生儿泪囊炎
早产儿视网膜病
先天性髋关节脱臼
新生儿脐疝
第二篇 婴儿期常见病防护宜与忌
呼吸系统疾病
感冒
百日咳
先天性喉喘鸣
皮肤病
湿疹
荨麻疹
尿布疹
痱子
药物性皮疹
消化系统疾病
婴儿腹泻
婴儿肠套叠
婴儿肠绞痛
先天性巨结肠
呕吐
便秘
循环系统疾病
先天性心脏病
心力衰竭
血液系统疾病
营养不良性贫血
血小板减少性紫癜
白血病

Book Abstract

新生儿产伤
头皮血肿
1.什么是头皮血肿
一种情况是胎儿在出生过程中,胎头受子宫口过度挤压而发生水肿,形成一个包顶在头上。这个包称之为“先锋头”或“产瘤”,属正常现象。两三天内可逐渐变小吸收,不需任何处理。
另一种情况是胎头在产道中受到过度挤压后头颅明显变形,骨与骨膜间发生迁移,造成血管破裂,骨膜下出血,形成血肿。这个血肿可大可小,与受挤压的程度及损伤血管的粗细有关。一般在出生后两三天,当头皮水肿吸收后血肿可逐渐增大,三四天后停止增大,触之有波动感。
2. 防治宜与忌

★头皮血肿除个别新生儿可加重黄疸及贫血外,一般无特殊症状,局部也无疼痛。血肿吸收较慢,需一两个月才能逐渐吸收机化(从边缘变硬,然后逐渐全部变硬)。在开始吸收机化时,血肿边缘高起,中间凹下,像个碟子,这不是头颅缺损,而是血肿机化的表现,不需求医,不必做任何处理。

★为防止感染,千万不可用针对头皮血肿处进行抽血处理。
胸锁乳突肌血肿
1.什么是胸锁乳突肌血肿
有少数新生儿(特别是臀位产儿)在出生时未见异常,出生后10~20天家长会发现在婴儿的颈部一侧肌肉(胸锁乳突肌)的中下部有一个直径约2厘米~3厘米大小的包块儿,呈圆形或椭圆形,质地硬,可移动,外观不红,抚之不热,触之不痛。这可能是在分娩过程中颈部过度向一侧牵拉,造成胸锁乳突肌损伤而形成的血肿;但也有因胎儿在宫内胎位不正,受到压力而颈部结构改变所致;还有人认为是胸锁乳突肌的先天缺陷,患儿大多有家族史。具体病因目前还不很明确,这种孩子的头向有肿块的一侧倾斜,而下颌及面部则转向无肿块的一侧,孩子成了歪脖子,也就是斜颈。本病为先天性可能性较大,故在新生儿期就应给予治疗。
2. 防治宜与忌

★用纱布袋或枕头使小儿头颈保持正位。让光源来自有肿物的一侧,小儿头部常转向光亮处,对防止病侧肌肉萎缩有一定帮助。
★在胸锁乳突肌包块处做按摩推拿治疗,从轻到重,圆周按摩,每天上下午各1次,每次按摩做250~300次。
★固定小儿的两侧肩部,然后给头部做被动运动,下颌向病侧旋转,头向正常的一侧转,每天牵拉四五次,每次5~10分钟。

★此病忌延误病情。经上述处理,多数孩子可痊愈,若患儿半岁仍未痊愈,就要及早考虑外科手术治疗,以免引起头面部发育不对称,造成终生遗憾。
骨折
1.骨折的原因及表现
新生儿因产伤骨折并不少见,主要原因是产妇在分娩过程中用力不当,用力过猛或助产人员动作粗暴及技术不够熟练。也有在分娩过程中,胎儿迅速下降,前肩胛部挤向产妇骨盆耻骨联合处,使锁骨极度弯曲而发生的自然骨折。锁骨骨折的部位一般在生理弯曲较细的地方,多以一侧为主。
新生儿骨折后常有明显的移位和成角畸形,但是远期观察,肢体功能往往可以自行恢复。其特点是骨痂出现得早,愈合得快,塑形功能强,愈合一般均较好。最常见的骨折部位就是锁骨骨折,但很少见因锁骨骨折引起的肢体活动障碍及肩部畸形。例如,一产妇第一胎,足月分娩一女婴,体重4000克,孩子出生后不停地哭闹,将孩子抱起来哭闹更甚。医生体检发现,孩子头顶上顶着个鸡蛋大小的包包(头皮水肿),右上肢活动不灵活,做牵拉时孩子哭闹加重。医生用双手对称性地触摸其双侧锁骨,发现右锁骨中段有骨的摩擦声,左锁骨完好,立即拍X光片,证实右锁骨中段错位性骨折,孩子哭闹的原因找到了。医生告之家长不必紧张,患儿会自行痊愈,不会留有任何后遗症。患儿骨折侧上肢活动可出现一时性受限,是由于活动时局部疼痛而呈现“假性麻痹”。患儿也可使痛肢紧贴胸部呈现自我保护性的功能位。骨折处次日可有外表肿胀、皮下瘀血,局部伴有骨的摩擦声。也有不完全性骨折(青枝骨折),在分娩当天触诊无明显变化,而在软组织发生肿胀时才被发现。这种骨折没有错位,X光片显示对线性或骨皮质裂开,这种骨折较错位性骨折愈合快。
2. 防治宜与忌

★对锁骨骨折的处理,过去主张以∞字形绷带固定两周。近几年来,经过许多人对几百例病人的观察,发现可不做任何处理。随着小儿的生长发育、肩部增宽,错位及畸形均可自行矫正,不会留有后遗症,病症早期护理动作轻柔即可。

★对于新生儿骨折的处理忌方法单一,应根据具体骨折类型给予相应处理,例如产伤性骨折中常见的还有肱骨骨折、股骨骨折,多发生于难产儿,这两种骨折用小夹板固定2周后即可痊愈。
臂丛神经麻痹
1. 什么是臂丛神经麻痹
孩子是家长的希望和未来,当孩子顺利分娩后,每个做父母的都希望他们活泼健壮。可是由于难产,不可避免地会造成婴儿一侧上肢活动受限、肩不能外展、上臂不能抬起、手不能抓握、患肢垂于体侧,有时还伴有同侧眼睑下垂、眼裂变小、瞳孔缩小,以上症状均为臂丛神经麻痹所致。
臂丛神经是由颈5~8及胸一二脊神经构成。第五颈神经根及第六颈神经根(臂丛的上根)最易受到损伤。在分娩时,过度地向一侧牵拉胎头,或臀位产时,头部尚未娩出即向下牵拉抬肩,易致臂丛下束损伤,引起上肢继发性麻痹。根据损伤部位可分成3类:
(1)上臂型
约占60%~70%,主要损伤在第五颈神经、第六颈神经的前干接触处。新生儿出生后患肢垂于身侧,上臂内收、内旋,前臂旋前,肘部微曲,肩关节内收而不能外展,拥抱反射消失。
(2)前臂型
约占10%,主要损伤第八颈神经和第一胸神经。表现为手的瘫痪,手指活动消失,大小鱼际肌萎缩,腕部不能动。
(3)全臂型
约占20%左右,臂丛神经束均有不同程度损伤。表现为整个上肢呈完全弛缓性瘫痪,感觉也可丧失,预后较差。
……

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