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【目的】探讨窒息新生儿并发缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)的危险因素。【方法】2008年1月—2009年6月在本科住院的新生儿窒息患儿98例(胎龄≥37周),其中32例并发HIE。对比分析窒息新生儿并发HIE组(n=32)与窒息新生儿未并发HIE组(n=66)的围产因素。【结果】HIE组患儿出生后1 min和5 min低Apgar评分率较非HIE组明显增加(P<0.05),5 min内复苏成功者(5 min Apgar评分>8分)发生HIE率较5 min内复苏未成功者明显降低(2χ=82.64,P<0.001)。HIE组死亡率明显高于非HIE组患儿(χ2=74.49,P<0.001)。HIE组患儿孕母不规范产前检查、脐带脱垂、胎盘早剥、男性患儿和过期产患儿均明显高于非HIE组(P<0.05)。不规范产前检查、过期产和1 min低Apgar评分与HIE的发生具有显著相关性(P<0.05)。【结论】高度关注HIE高危因素,减少新生儿窒息,做好产时复苏工作对预防HIE有重要意义。
【Objective】 To investigate the risk factors of neonatal asphyxia neonatoral hypoxic-ischemic encephalopathy (HIE). 【Methods】 From January 2008 to June 2009, 98 infants with neonatal asphyxia (gestational age ≥37 weeks) hospitalized in our department were enrolled. Among them, 32 cases were complicated with HIE. The perinatal factors of asphyxia neonates complicated by HIE group (n = 32) and asphyxiated neonates without HIE group (n = 66) were compared. 【Results】 The HIE rates of children with HIE at 1 minute and 5 minutes after birth were significantly higher than those of non-HIE rats (P <0.05), and those with successful recovery within 5 minutes (5 min Apgar score> 8) The number of patients who failed to recover within 2 months was significantly lower (2χ = 82.64, P <0.001). HIE group mortality was significantly higher than non-HIE group (χ2 = 74.49, P <0.001). HIE group of children with prenatal non-standardized prenatal care, umbilical cord prolapse, placental abruption, male children and children with obesity were significantly higher than non-HIE group (P <0.05). Irregular prenatal care, obsolete births, and 1-minute low Apgar scores were significantly associated with the occurrence of HIE (P <0.05). 【Conclusion】 High attention to the risk factors of HIE, reduce neonatal asphyxia and do a good job in the recovery of labor during the production of HIE is of great significance.