462例新生儿窒息原因及预后分析

Analysis on the Causes and Prognosis for 462 Cases of Neonatal Asphyxia

目的分析某院新生儿窒息原因及预后,为制定临床救治方案和监护措施提供参考依据。方法应用病案统计系统和国际疾病分类(ICD-10)检索统计2015年1月1日-2019年12月31日某院产科出生的新生儿总数22024例,从病案首页中提取产科出院所有疾病诊断编码中含有P21.102或P21.000的出院病例,并从分娩记录信息中提取新生儿窒息原因。从某院新生儿病区出院病案首页主要诊断编码为P21.102或P21.000的出院病例中筛选出在产科发生窒息的新生儿病案,并统计轻度窒息及重度窒息新生儿数以及死亡新生儿的胎龄、体重。结果医院5年期间发生新生儿窒息257例,其中轻度窒息214例、重度窒息43例,占同期出生新生儿总数的1.17%。新生儿窒息率逐年递减,且总体下降趋势有统计学差异。257例窒息新生儿中死亡4例,占同期出生新生儿总数的0.18‰。新生儿窒息主要原因依次为脐带异常、胎盘功能减退、胎膜早破、低体重儿、胎粪误吸、羊水异常。结论针对新生儿窒息原因医院和孕妇应重视围产期保健,加强产时监护,制定合理的分娩方案,加强儿科与产科的衔接工作,可降低新生儿窒息率及改善预后。

Objectives To analyze the causes and prognosis of neonatal asphyxia in a hospital,then to provide reference for the development of clinical treatment plan and monitoring measures.Methods The total number of newborn in the obstetrics department of the hospital from January 1 st,2015 to December 31 st,2019 was retrieved by using the medical record statistics system and the international classification of diseases(ICD-10)code,and the discharge cases containing P21.102 or P21.000 code in all diagnoses of obstetric discharge were extracted from medical record front page,and the causes of neonatal asphyxia were extracted from the bi rth record information.Then,in medical record home page from the neonatal ward,the main diagnostic code was P21.102 or P21.000 for discharged cases,from which the medical records of newborns with asphyxia in the obstetrics department of the hospital were screened,and the number of newborns with mild asphyxia and severe asphyxia,as well as the gestation age and weight of dead newborns were counted.Results A total of 22024 neonates were born in the obstetrics department of the hospital during the five-year period,of which 257 cases were neonatal asphyxia,including 214 cases cf mild asphyxia and 43 cases of severe asphyxia,accounti ng for 1.17%of the total number of newborns born in the same period.Neonatal asphyxia rate decreased year by year,and the overall trend of decline was statistically different.Among the 257 asphyxiated newborns,4 cases died,accounting for 0.18‰of the total number of newborns born in the same period.The main causes of neonatal asphyxia were umbilical cord abnormality,placental hypofunction,premature rupture of membranes,low body weight,meconium aspiration and abnormal amniotic fluid.Conclusions Hospitals and pregnant women should attach great importance to perinatal health care,strengthen prenatal monitoring,formulate reasonable childbirth plans,and strengthen the work of linking pediatrics and obstetrics,which could reduce the neonatal asphyxia rate and improve the prognosis.