西宁地区新生儿缺氧、缺血性疾病的预测及对策

目的：分析西宁地区(海拔2260m)围产期缺氧缺血性疾病发生的主要原因，做到早期预防，并探讨如何有效降低死亡率和后遗症的发生率，坚持恢复期治疗及早期干预康复治疗。方法：对60例新生儿缺氧缺血性疾病(HID)包括脑、心肺、肾和胃肠道等主要器官受损结果进行资料分析。结果：在60例HID中新生儿缺氧缺血性脑病(HIE)31例，缺氧缺血性心肺损伤12例，胃肠道功能障碍10例，肾功能不全7例。经治疗存活42例(70％)，死亡19例(30.1％)，放弃3例(5％)。妊娠后期胎儿长期缺氧致脏器损害，较出生时各种原因所致窒息重，预后差。维持新生儿较高血糖水平。明显优于低正常水平血糖。早期高压氧治疗也是重要手段之一。结论：产科、儿科进一步合作，重视宫内监护，完善新生儿复苏设备和技术培训，是预测HID和最大限度地降低死亡率，控制并发症的关键。在高原地区正常孕妇应改善血液粘稠度，提高子宫胎盘血流量，改善胎盘功能以利妊娠。

Predication and Treatment of Hypoxic and Ischemic Diseases in Newborn at High Altitude

Objective: To study the predicated way and the treatment of hypoxic and iscahemic diseases (HID) in newborn at high altitude. Method: The data of 60 cases, which had the HID in brain, heart, lung and gastrointestinal tract, were reviewed. Results: 31 of 60 cases had the hypoxic and ischemic encephalopathy (HIE), 12 cadiopulmonary injury, 10 dysfunction of gastrointestinal disease and 7 renal dysfunction. Of all cases were treated, result showed that 70% had been cured, 30.1% dead and others were not available. Conclusions: It is important that the pediatrics cooperated with the 0bstetrics and the intrauterine detection was performed by advance technique for predication of HID in newborn. And the treatment of complications of HID is a key about decreasing newborn deed at high altitude.