新生儿缺氧缺血性心肌损害的发病因素和影响预后因素的临床研究

本文分析了一组并发心肌损害的窒息新生儿,发现胎儿宫内窘迫、窒息复苏后酸中毒和低氧血症是导致心肌损害的危险因素;心力衰竭和缺氧缺血性脑病等窒息并发症是影响预后的主要因素。

CLINICAL STUDY ON THE CAUSATIVE FACTORS OF HYPOXIC-ISCHEMIC MYOCARDIAL INJURY AND THE CAUSES OF DEATH IN NEONATES

Clinical data were analysed in 58 asphyxic neonates to explore the risk factors of hypoxic-ischemic myocardial injury and the causes of death. The results showed that the disress in fetus, acidosis and hypoxemia after resuscitation of asphyxia were the causative factors of myocardial injury. The assocation of death was mainly the prognostic agents, heart failure and hypoxic-ischemic encephalopathy which were defined by logistic regression model, The relative risk degree (RR) of death was 17 if the heart failure existed alone. RR would be 162 if both heart failure and encephalopathy existed simultaneously because of their combined effect. Thus, the principles of prevention and management of hypoxic-ischemic myocardial injury should be prevention of perinatal insults, prompt correction of acidosis and hypoxemia, supply of efficient energy, more urgent and active treatment of heart failure and other asphyxic complications such as encephalopathy.