新生儿窒息多器官损害的临床研究

为了解窒息后多器官损害的发生率、临床特点及围产因素与多器官损害间的关系，对本院１４７例窒息新生儿进行了分析。结果：（１）窒息后器官损害的发生率为７４．８％，脑损害的发生率为６５．３％，其中轻中度８１例，重度１５例，肾脏损害４２．９％，肺脏损害３７．４％，心脏损害３３．３％，胃肠损害５．４％；（２）轻度窒息的多器官损害为２８．１％，明显低于重症窒息的６９．６％（Ｘ２＝２５．２５，Ｐ＜０．０１）；（３）器官损害的发生率及严重程度与孕周、重度窒息、５分钟Ａｐｇａｒ评分＜５分及机械通气相关，而与羊水胎粪污染程度及宫内窘迫关系不大。提示：应加强围产期保健，预防早产，防止窒息，推广新法复苏及复苏后监护。

A clinical study on multiorgan invol vement in neonatal asphyxia

The purpose of this study was to evaluate the incidence and clinical feaures of multiorgan involvement and to analyze the relation between perinatal factors and multiorgan involvement. One hundred and forty seven newborn infants with perinatal asphyxia were studied prospectively. The results showed that (1) the incidence of organ involvement after asphyxia was 74.8% including central nervous system involvement (65.3%), renal involvement (42.9%), pulmonary involvement (37.4%), cardiac involvement (33.3%) and gastrointestinal involvement (5.4%); (2)the frequency of multiorgan involvement in mild asphyxia (28.1%) was obviously lower than that in severe asphyxia (69.6%) (X 2=25.25,P<0.01);(3)the incidence and severity of organ invlvement after asphyxia were related to the gestational age, degree of asphyxia, Agar score (<5 at 5 minutes) and mechanical ventilation instead of meconium stained amniotic fluid and intrauterine asphyxia.