摘要
目的通过对我院170例新生儿重度窒息病例的临床资料、各脏器受累及损伤程度进行分析,了解其与死亡有关的危险因素,以进一步降低死亡率。方法对1993年1月至2004年3月我院新生儿加强监护病房收治的170例重度窒息新生儿的临床资料进行分析。结果170例中死亡22例,病死率为12.5%。165例出现各脏器损伤,占97.1%;各脏器受累的先后次序依次为神经系统、呼吸系统、代谢系统;严重程度依次为代谢系统、呼吸系统、神经系统等。胎龄、出现严重的神经系统症状、呼吸系统受累、呼吸衰竭、严重代谢性酸中毒或呼吸性酸中毒、电解质异常及心脏、代谢系统、血液系统、肝脏受损为死亡的危险因素。3个以上脏器受损或1个脏器严重受损亦与死亡相关;10minApgar评分≤3分以及5和10minApgar评分的分值均与死亡相关。结论重度窒息新生儿易发生多脏器受损,严重威胁患儿生命。因此应做好围产期监护,避免胎儿宫内缺氧,一旦发现宫内缺氧,应及时处理,尽早终止妊娠。对重度窒息新生儿,更应加强对各系统的整体监护,减少并减轻脏器的受累,以降低病死率,减少后遗症的发生。
Objective To investigate the clinical condition, the number and degree of organal damage in the neonates with perinatal asphyxia and to analyze the risk factors of death. Methods Analyzed the risk factors affecting neonatal death in 170 infants with severe perinatal asphyxia retrospectively with SAS software, t-test and odds ratio. Results 22/170 infants （12.5％） died and 165/170 infants （97.1％） had organal damage in the order of metabolic system, respiratory and nervous system. The risk factors of death were fetal age, serious involvement of nervous system, respiratory failure, serious metabolic or respiratory acidosis, electrolyte disturbance,heart, liver damage and damage to the hemopoietic system. Organal damage more than three organs or severe damage of one organ was all death-associated. 10 min Apgar score≤3 and 5 min, together with 10 min Apgar score splitting values was also death-related. Conclusions Severe neonatal asphyxia can lead to multiple organal damage, threatening the life of neonates, hence, perilabor monitoring, avoidance of intrauterine hypoxia are all important to reduce the rate of neonatal death and occurrence of sequelae. （Shanghai Med J, 2005,28：572-575）.
出处
《上海医学》
CAS
CSCD
北大核心
2005年第7期572-575,共4页
Shanghai Medical Journal
