230例新生儿缺氧缺血性脑病10年回顾性调查及围产因素分析

10-year-retrospective Survey and Perinatal-factor Analysis on 230 Cases with Hypoxic-ischemic Encephalopathy

目的 分析围产因素对新生儿缺氧缺血性脑病 (HIE)发病的影响。方法 对 2 30例HIE患儿性别、胎龄、出生体重、临床表现、母亲孕期病史及分娩情况进行回顾性分析。结果 导致HIE发生的产前异常因素以不良分娩史 (2 5 81% )、妊娠高血压综合征 (2 3 6 6 % )、胆汁淤积症 (17 2 0 % )、双胎 (10 75 % )、前置胎盘 (7 5 3% )为主。产时异常因素以羊水污染 (2 5 36 % ) ,胎膜早破 (16 75 % ) ,胎心改变 (15 79% ) ,脐带异常 (14 35 % ) ,第二产程延长 (13 88% )为主。同时HIE的发生与分娩方式、早产、低出生体重、Apgar评分相关。结论 增强孕妇自我保健意识 ,加强围生期保健 ,提高基层医疗机构产科质量 ,根据不同产妇和胎儿的具体情况 ,采取适当的个体化干预措施 ,对预防和减少新生儿HIE的发生 ,降低围产儿死亡率和致残率具有重要意义。

Objective To analyze the effect of perinatal factors on the neonatal hypoxic-ischemic encephalopathy.Methods A retrospective analysis was carried out for 230 neonates with hypoxic-ischemic encephalopath,which was mainly about sex,age,weight,clinic presentation,mother′s pregnant history and delivery status.Results The major abnormal factors of HIE are delivery history (25.81%),pregnancy induced hypertension syndrome(23.66%),intrahepatic cholestasis of pregnancy (17.20%),twin pregnancy (10.75%),placenta praevia (7.53%) before delivery,meconium stained amniotic fluid (25.36%),premature rupture of fetal membranes (16.76%),fetal heart change (15.79%),Abnormality of umbilical cord (14.35%) and the duration of the second stage of labor (13.88%) during delivery,at the same time,it was relative to the mode of delivery,early birth delivery,lower weight and Apgar scores.Conclusion Improving the consciousness of self-health care of the pregnant women,strengthening health care in pregnant period,improving the quality of obstetrics of fundamental medical administration,improving the quality of obstetrics of the basic medical administration,adopting appropriate individual preventing measures according to the detailed situation of different puerperals and fetus,are significant to prevent and decrease the occurrence of HIE in neonates,lower the incidence rate and the mortality rate.