신생아 혈압 정상치 - sinsaeng-a hyeol-ab jeongsangchi

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<혈압>
건강만삭아 SBP 56-77mmHg, DBP 33-50mmHg, MBP 42-60mmHg
미숙아 MBP가 800g이하의 경우 주수보다 낮게 나올 수 있음
-상하지 혈압 비교; 상지의 SBP가 하지보다 20mmHg 높을시..
->대동맥협착, PDA는 이런 차이를 감춤
대동맥궁 이상; 동시에 두 팔과 다리 한쪽 혈압 측정, 하행대동맥의 결함 수준 이하로부터 혈액공급이 양다리로 가기 때문에 어느 다리로도 평가 가능

-신생아 고혈압, 신장의 구조및 이상은 고혈압의 가장 흔한 원인
만삭아 SBP>90mmHg, DBP>60mmHg
미숙아 SBP>80mmHg, DBP>50mmHg

<infantogram>
-폐
air bronchogram; 공기로 채워진 기관지의 검은부분(air)은 더 하얀 부분(무기폐)인 폐영역의 증가된 방사선 불투과성 음영과 대비됨. (정상; 전부 검정색)
carina; 기관지의 분기점. 3~4번째 흉추에 위치, 기관내관 위치 결정시 사용
과대팽창된 폐; 9번째 늑골 이상으로 더 확장

태그

�Ż����� ������ ���ɿ� ���� ���� ����ġ�� ���� ���� Study of the Normal Value of Neonatal Blood Pressure according to Postconceptional Age

�Ҽ� ������

������/Jin Ah Kim ������/�����/Eun Ae Park/Gyoung Hee Kim

KMID : 0361719990100010003   

Abstract

���
�Ż����� ������ Ȱ��¡���� �ϳ��� �Ż����� �ǰ��� �ľ��ϰ�, �ΰ�������, ������, ����
���� ���� ��ȯ�� �־� �ſ� �߿��ϳ�, ������ ����ġ �ʰ�, ���б��� ����, ��������� ��
�� ������ ���� �� �ƴ϶� ���±Ⱓ�� ����� ü��, �ֻ�� ������ ����, ���� �ð��� ���
�� �������� Ȱ�����¿� ���� �޶����� ������ �˷����ִ�(Ashworth and Neligan, 1959 :
Bowman, 1933).
���ڵ��� �������� �������� ����� ���Ƴ� ����ġ�� �� ��ġ�ϴ� ������ �˷���
oscillometry���(���ö� ��, 1988, Baker and Maisels, 1984, Friesen and Lichtor, 1981)��
���Ͽ� �̼��Ƹ� ������ 448���� �Ż��Ƹ� ������� ���� �� ���ɿ� ���� ������ ����ġ��
�˾ƺ���, ���� �� ����, ����� ü��, üǥ����, ���� ����, ���� ���� �Ż����� ���п� ��
ġ�� ����� ��� ������ ���п� ���� ū ������ ��ġ�� �� �˾ƺ����� �� ������ ������
����.
���� 448���� ������� ��908�ʿ��� �������б�(Oscillometric device, Dinamap 1846,
critikon. Inc.)�� �̿��Ͽ� ���� 1��, 3��, 5���� ������ �����Ͽ���, �� �̼����� ���� ��
�� 1�� �������� �ݺ� �����Ͽ� ���� �� ���ɿ� ���� ������ ����ġ�� ���Ͽ���. ���� ����
�� ����, ���� ����, ����� ü��, üǥ����, ���� �� ���� ���ΰ� ���а��� ���迡 ���Ͽ�
�м��Ͽ� ��� ������ ���п� ���� ū ������ ��ġ���� �����Ͽ��� ������ ���� �����
�����.
1) �Ż����� ������ ���� �� ����(R=0.204, p<0.05), üǥ����(R=0.191, p<0.05 ), �����
ü��(R=0.183, p<0.05)�� ������踦 ��������, ������ ���� ���̴� ������. ����Ʊ����� ��
�� ���ɰ� ���а��� ���� ���� ������谡 �־���(R=0.022, p<0.05). �Ż����� ���п� ����
�� ��ġ�� ���� ���� �߿��� ���� �� ������ ���� ���� ��Ÿ����.
2) �� ���� �� ���ɿ� ���� ��������а� �̿ϱ������� ����ġ�� mean��2SD���� ��Ÿ��
����, 28�̸ֹ�(n(�˻��)=27)������ ��������� 50.4��23.1mmHg, �̿ϱ����� 26.2��
12.8mmHg, 28�� �̻� 32�̸ֹ�(n=63)������ ��������� 60.1��30.6mmHg, �̿ϱ����� 33.6
��16.7mmHg, 32�� �̻� 32�̸ֹ�(n=139)������ ��������� 63.2��20.4mmHg, �̿ϱ�����
37.7��19.8mmHg, 36�� �̻� 40�̸ֹ�(n=543)������ ����� ���� 65.6��18.5mmHg, �̿ϱ�
���� ��.6��17.3mmHg, 40�� �̻�(n=136)������ ��������� 67.7��16.9mmHg, �̿ϱ�����
39.3��15.8mmHg�� ���� �� ���ɿ� ���� ������ ��ȭ�� �ǹ��ְ� ����Ͽ���(R=0.204,
p<0.05).
�̿� ���ڵ��� �̼��ƿ� ���� ����Ż����� ���п� ������ ��ġ�� ���� ���� �߿��� ����
�� ����, üǥ����, ����� ü�߰� ������ ������ ������谡 �ִ� ���� ��������, �̵� ��
���� �� ������ ���� ���谡 �����Ƿ� ���� �� ������ �������� �� ������ ����ġ�� �̿���
�� ���� Ÿ���� ������ �����Ǹ�, �׿� ���� ����ġ�� �����ϴ� ���̴�.
#�ʷ�#
Objective : Neonatal blood pressure is one of the vital signs used to assess the
general health of a newborn infect. But, it is difficult to measure and varies according
to the model of sphygmomanometer, the used method, the postconceptional age, birth
weight, asphyxia, postnatal age and activity.
We have assessed the mean value of blood pressure(BF) according to postconceptional
age. Variations caused by the postconceptional age, birth weight, body surface
area(BSA), postnatal age, and sex were analyzed to determine the most important factor
influencing the neonatal BP.
Methods : This study included 448 normal fullterm infects and healthy preform infants
born from fan. 1995 to Aug. 1997 at Ewha Dongdaemoon and Mokdong Hospital. The
BP was taken on day 1, 3, 5 with the oscillometric device(Dinamap 1846 critikon Inc.),
for premature infants BP was 1311owe4 up every week afterward.
Results : The neonatal BP was related to the postconceptional age(R=0.204, P<0.05),
BSA(R=0.191, P<0.05), birth weight(R= 0.183, P<0.05) and the postnatal age in fullterm
infects(R=0.022, P<0.05) but not with the sex of the infect. The postconceptional age
was the most significant variable among those influencing the BP. The normal value of
the systolic and the diastolic BP was expressed as mean��2SD according to the
postconceptional age, less than 28 weeks(n=27) systolic/diastolic pressure 50.4��
23.1mmHg/36.2��12.8mmHg, 28-32weeks(n=63) 60.1��30.6mmHg/33.6��16.7mmHg,
32-36weeks(n=139) 63.2��20.4mmHg/37.7��19.8mmHg, 36-40weeks(n=543) 65.6��
18.5mmHg/38.6��17.3mmHg, more than 40weeks(n=136) 67.7��16.9mmHg/39.3��15.8mmHg.
The increase in blood prssure with the postconceptional age was statistically significant.
Conclusion : The normal range of neonatal BP, especially preform infants, was
presented, and it would be much valuable 1)r the evaluation of BP in neonate if
standardized by postconceptional age.

����

Postconceptional age; Prematurity; Blood pressure;

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KCI

KoreaMed

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