论文部分内容阅读
目的探索影响新生儿缺氧缺血性脑病(HIE)的发病危险因素以及预后情况,为今后的临床诊治提供参考。方法选取新都区第二人民医院2010年4月-2014年11月收治的106例HIE患儿作为观察组,选择同时期出生的健康婴儿110例作为对照组。观察组患儿出院后6个月进行随访。采用自行设计的调查问卷进行发病危险因素和预后情况调查。结果患儿发病的危险因素为妊娠期高血压(OR=9.631,95%C.I.=5.229~16.492)、脐带异常(OR=7.675,95%C.I.=4.998~10.338)、1 min Apgar评分低(OR=6.586,95%C.I.=3.872~10.224)、胎膜早破(OR=3.326,95%C.I.=1.986-4.229)、宫内窘迫(OR=2.365,95%C.I.=1.394~4.211)以及产程异常(OR=2.021,95%C.I.=1.093~3.281)。患儿6个月时预后不良率为26.5%。尽早进行药物和智能干预(OR=5.403,95%C.I.=3.908~7.293)、正规治疗开始时间≤48 h(OR=4.254,95%C.I.=3.801~7.022)、5min Apgar评分低(OR=2.807,95%C.I.=1.782~4.764)以及CT分度低(OR=2.353,95%C.I.=1.782~4.764)的患儿的预后良好。结论 HIE的发病及预后受到多种因素的共同影响。在怀孕及分娩过程中,需尽量识别并减少宫内窘迫或窒息情况的发生。对于HIE患儿,需尽早进行正规的治疗和干预。Apgar评分是HIE发病及预后较为敏感的指标。
Objective To explore the risk factors and prognosis of neonates with hypoxic-ischemic encephalopathy (HIE) and provide reference for future clinical diagnosis and treatment. Methods A total of 106 children with HIE admitted from April 2010 to November 2014 in Second People’s Hospital of Xindu District were selected as the observation group and 110 healthy infants born at the same period were selected as the control group. Children in the observation group were followed up for 6 months after discharge. Using self-designed questionnaire for risk factors and prognosis survey. Results The risk factors for the onset of hypertension in children were gestational hypertension (OR = 9.631, 95% CI 5.229-16.492), umbilical cord abnormality (OR = 7.675, 95% CI 4.998-10.338) 6.586, 95% CI = 3.872-10.224), premature rupture of membranes (OR = 3.326, 95% CI = 1.986-4.229), intrauterine distress (OR = 2.365,95% CI = 1.394-4.211) = 2.021, 95% CI = 1.093 ~ 3.281). The prognosis of children with 6 months poor rate of 26.5%. As early as possible, drug and intelligence intervention (OR = 5.403, 95% CI = 3.908-7.293), regular treatment start time≤48 h (OR = 4.254, 95% CI = 3.801-7.022) 95% CI = 1.782-4.764) and children with low CT (OR = 2.353, 95% CI = 1.782-4.764) had a good prognosis. Conclusions The incidence and prognosis of HIE are influenced by many factors. In pregnancy and childbirth, the need to identify and reduce the incidence of intrauterine distress or asphyxia. For children with HIE, regular treatment and intervention are required as soon as possible. Apgar score is HIE incidence and prognosis more sensitive indicators.