窒息新生儿并发缺氧缺血性脑病危险因素分析

【目的】 探讨窒息新生儿并发缺氧缺血性脑病(hypoxic-ischemic encephalopathy, HIE)的危险因素。 【方法】 2008年1月—2009年6月在本科住院的新生儿窒息患儿98例(胎龄≥37周),其中32例并发HIE。对比分析窒息新生儿并发HIE组(n=32)与窒息新生儿未并发HIE组(n=66)的围产因素。 【结果】 HIE组患儿出生后1 min和5 min低Apgar评分率较非HIE组明显增加(P<0.05),5 min内复苏成功者(5 min Apgar评分>8分)发生HIE率较5 min内复苏未成功者明显降低(χ²=82.64,P<0.001)。HIE组死亡率明显高于非HIE组患儿(χ²=74.49,P<0.001)。HIE组患儿孕母不规范产前检查、脐带脱垂、胎盘早剥、男性患儿和过期产患儿均明显高于非HIE组(P<0.05)。不规范产前检查、过期产和1 min低Apgar评分与HIE的发生具有显著相关性(P<0.05)。 【结论】 高度关注HIE高危因素,减少新生儿窒息,做好产时复苏工作对预防HIE有重要意义。

Risk factors for hypoxic-ischemic encephalopathy in asphyxiated newborn infants

【Objective】 To determine the risk factors for hypoxic-ischemic encephalopathy(HIE) in asphyxiated newborn infants. 【Methods】 A retrospective study of 98 asphyxiated newborn infants(gestational age ≥ 37 weeks) in our hospital from January 2008 till the end of June 2009,and 32 newborn infants were complicated by HIE.The clinical data of the HIE group(n=32) were compared with those of the HIE negative group(n=66). 【Results】 The incidences inappropriate antenatal care,prolapsed cord,abruptio placenta,male and post-term gestation in the HIE group were significantly higher than those in HIE negative group(P<0.05),the 1 and 5-minute Apgar scores were significantly lower in the HIE group than those in HIE negative group(P<0.05),a 5-minute Apgar score of 3 or less in infants had a high risk of neonatal death in HIE infants and asphyxiated infants(P<0.05).Inappropriate antenatal care,1min and 5 min Apgar score had significant relation to HIE occurrence after birth asphyxia(P<0.05). 【Conclusion】 It is very important for the prevention of HIE that these risk factors should be highly concerned to minimize birth asphyxia.