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本文对50例围产窒息新生儿进行了前瞻性观察,以研究围产窒息对新生儿心血管系统的损害。50例中宫内窘迫5例,初生窒息40例,初生窒息伴宫内窘迫5例。轻度窒息14例,重度36例。初生8小时内做血气分析有低氧血症、代谢和呼吸性酸中毒。初生3天内做心电图,异常者占88％,以ST-T波改变最多见。初生3天内胸片示心脏扩大,心胸比平均值0.64±0.05。心肌酶谱检查GOT、LDH、CPK总酶和CPK-MB皆高于正常新生儿。7例合并动脉导管未闭,5例用消炎痛关闭,4例成功,1例无效。另2例初生1周后自行关闭。7例有心功能不全的表现。6例发生窦性心动过缓,心室率60～90次/分,2～3天恢复。死亡6例,5例死于肺、脑合并症,1例死于持续胎儿循环及休克。3例尸解有广泛性心肌空泡变性,2例有心室腔扩大,说明有严重心肌受损。对于窒息后心功能不全主张用多巴胺或多巴酚丁胺配合血管扩张药酚托拉明等治疗。
In this paper, 50 cases of perinatal asphyxia were prospectively observed in neonates to study the perinatal asphyxia damage to the cardiovascular system. 5 cases of intrauterine distress in 50 cases, 40 cases of primary asphyxia, 5 cases of neonatal asphyxia with intrauterine distress. Mild asphyxia in 14 cases, severe in 36 cases. 8 hours of newborn blood gas analysis of hypoxemia, metabolism and respiratory acidosis. Electrocardiography within 3 days of birth, abnormal persons accounted for 88%, ST-T wave to change the most common. Within 3 days of birth, the chest radiograph showed an enlarged heart with an average heart-chest score of 0.64 ± 0.05. Myocardial enzymes check GOT, LDH, CPK total enzymes and CPK-MB are higher than normal newborn. 7 cases with patent ductus arteriosus, 5 cases with indomethacin closed, 4 cases were successful, 1 case was ineffective. Another 2 cases of newborn after 1 week off. 7 cases of heart failure performance. 6 cases of sinus bradycardia, ventricular rate of 60 to 90 beats / min, 2 to 3 days recovery. 6 died, 5 died of lung and brain complications, 1 died of persistent fetal circulation and shock. 3 cases of autopsy with extensive myocardial vacuolation, 2 cases of ventricular cavity enlargement, indicating a serious myocardial damage. For asphyxia after cardiac insufficiency claims dopamine or dobutamine with vasodilator drug tiaolimin and other treatment.