新生儿缺氧缺血性脑病国内与国际诊断标准的诊断价值比较

目的比较国内与国际诊断标准对新生儿缺氧缺血性脑病(HIE)的诊断价值。 方法2002-01—2004-06，对山东曹县人民医院以国内标准诊断的126例HIE重新以国际标准进行回顾诊断，并加以比较。 结果126例中按国际标准，诊断符合率为80.16%(P<0.01)，胎龄≥37周和<37周HIE诊断符合率分别为86.13%(P<0.01)和57.14%(P<0.01)，日龄≤3d，~7d及>7d诊断符合率分别为75.00%(P<0.01)、84.38%(P<0.05)及94.44%(P>0.05)，病情轻度、中度及重度诊断符合率分别为73.44%(P<0.01)、87.18%(P<0.05)及95.65%(P>0.05)。 结论国内标准太偏松，易使HIE诊断扩大化，国际标准太严，易使HIE诊断发生漏诊，二者相结合，更科学合理，更适于国情。

Hypoxic ischemic encephalopathy diagnosed according to different criteria:national and international.

AbstractObjectiveTo compare the diagnostic value of national standard with international standard for HIE. MethodsA total of 126 neonates with HIE diagnosed first according to national standard were diagnosed again according to international standard.The diagnostic rate was compared. ResultsAccording to international standard,the diagnostic rate of 126 neonates with HIE was 80.16%(P<0.01).Fetus age being≥37 weeks and <37 weeks,it was 86.13%(P<0.01)and 57.14%(P<0.01) respectively.Admission age being≤3 days,~7 days and >7 days,it was 75%(P<0.01)84.38%(P<0.01) and 94.44%(P>0.05) respectively.Condition level being mild,moderate and severe,it was 73.44%(P<0.01),87.18%(P<0.05) and 95.65%(P>0.05) respectively. ConclusionThe national standard is very flabby as it expands diagnosis easily,while the international standard is too strict so it misses out diagnosis easily.If they are combined,it will be scientific and advisable,and suitable to national condition.