摘要
目的联合围生期因素及新生儿期因素探讨新生儿缺氧缺血性脑病短期预后不良的相关因素。方法回顾2016-11—2020-04在郑州大学第三附属医院分娩并入住新生儿科治疗的缺氧缺血性脑病活产新生儿的临床资料,根据最终结局分为预后良好组及预后不良组。比较2组患儿母亲围生期因素及新生儿期相关因素,组间采用χ^2检验及Spearman方法进行因素相关性分析,多因素Logistics回归分析处理影响HIE新生儿短期预后不良的独立因素。结果166例缺氧缺血性脑病新生儿中,预后不良29例(17.47%),不同组间羊水量、胎膜早破情况、脐带情况、羊水性质、孕期并发症、定期围生保健情况、保胎史、胎龄、出生体质量、Apgar 1 min评分、Apgar 5 min评分、BE值、pH值、新生儿呼吸窘迫综合征分级、呼吸暂停、新生儿窒息、新生儿呼吸衰竭、新生酸中毒预后不良率均有差异(P<0.05)。Logistic回归分析显示,胎膜早破、Apgar 1 min评分、Apgar 5 min评分,呼吸暂停情况、pH值均是影响新生儿缺氧缺血性脑病短期预后不良的独立因素(P<0.05),定期围生保健是预后不良的保护性因素。在预后不良组中,对围生期因素和新生儿期因素进行相关性分析,共有5对因素存在相关性,分别是羊水性质-新生儿体质量、脐带情况-新生儿窒息、胎膜早破情况-呼吸暂停情况、胎膜早破情况-新生儿呼吸窘迫综合征分级、胎膜早破情况-Apgar 1 min评分。结论新生儿缺氧缺血性脑病短期预后不良的影响因素较多,应及早从母亲围生期和新生儿期双方面给予高度关注和干预,以降低新生儿缺氧缺血性脑病短期预后不良率。
Objective To investigate the risk factors of poor short-term neonatal outcomes with hypoxic ischemic encephalopathy(HIE)combined with perinatal period and neonatal period.Methods To review the live births of HIE who were delivered in the Third Affiliated Hospital of Zhengzhou University from November 2016 to April 2020.According to the final outcome of the neonatal,they were divided into a good prognosis group and a poor prognosis group.χ^2 test and Spearman’s correlation analysis were used to analyze the correlation between the two groups.Multivariate Logistic regression analysis was used to analysis the independence factors of the short-term poor prognosis of neonatal hypoxic ischemic encephalopathy.Results Among 166 neonates with HIE,29 had a poor prognosis(17.47%).Compared with the good short-term,amniotic fluid volume,premature rupture of membranes,umbilical cord condition,amniotic fluid nature,pregnancy complications,regular perinatal care,tocolyis history,gestational age,birth weight,Apgar 1 min score,Apgar 5 min score,BE value,pH value,neonatal respiratory distress syndrome classification,apnea,neonatal asphyxia,neonatal respiratory failure and neonatal acidosis of poor prognosis rate there were differences.The differences between two groups were statistical significant(P<0.05).Logistic regression analysis showed that premature rupture of membranes,Apgar 1 min score,Apgar 5 min score,apnea,and pH value were all independent factors affecting the short-term poor prognosis of neonatal hypoxic ischemic encephalopathy(P<0.05),regular perinatal care was a protective factor for poor prognosis.In the poor prognosis group,the results of correlation analysis between perinatal factors and neonatal factors showed that a total of 5 pairs of factors were related.There were the nature of amniotic fluid-newborn weight,umbilical cord condition-neonatal asphyxia,premature rupture of membranes-apnea condition,premature rupture of membranes-neonatal respiratory distress syndrome classification,premature rupture of membran
作者
张金燕
王晨阳
郭晓丽
李军歌
苏元元
ZHANG Jinyan;WANG Chenyang;GUO Xiaoli;LI Junge;SU Yuanyuan(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国实用神经疾病杂志》
2020年第20期1835-1840,F0003,共7页
Chinese Journal of Practical Nervous Diseases
基金
河南省科技厅项目(编号:182102310394)。
关键词
新生儿
缺氧缺血性脑病
预后不良
母婴
Neonatal
Hypoxic ischemic encephalopathy
Poor prognosis
Maternal and infants
