重度新生儿窒息78例临床分析

Clinical analysis of 78 cases of critical asphyxia neonatorum

目的探讨预防新生儿窒息的措施,以降低新生儿窒息的发生率。方法收集该院78例重度新生儿窒息的临床资料,分析发病的相关高危因素。结果该院2003年1月至2004年12月新生儿窒息发生率为4.22%,其中重度新生儿窒息发生率为1.70%,矫正死亡率为8%。重度窒息的相关因素依次为胎儿宫内窘迫(47%)、早产(49%)、脐带因素(缠绕、脱垂及过短,32%)、臀位(26%)、重度妊娠高血压综合征(14%)、畸形(6%)、胎盘早剥及前置胎盘(6%)。结论加大孕产妇分级管理的力度,加强孕期保健和产前检查,及早发现和治疗妊娠高血压综合征,适时纠正臀位,尽量减少早产,及早发现和正确处理胎儿宫内窘迫,及早发现和处理畸形儿,制止非法接生,是降低新生儿重度窒息的有效措施。

Objective To investigate measures of preventing asphyxia neonatorum in order to reduce the rate of asphyxia neonatorum. Methods Clinical datas on a total of 78 cases of critical asphyxia neonatorum from the year 2003- 2004 in Longgang Central Hospital were collected and analyzed. Related high risk factors and effective precaution measures of reducing the rate of asphyxia neonatorum were studied. Results The rate of asphyxia neonato- rum from January 2003 to December 2004 was 4.22 % ,of which it was 1.70 % of Critical asphyxia neonatorum and 8 % of treated deaths. The first seven related factors to critical asphyxia neonatorum of this group Were：fetal distress （47 % ）, premature delivery （49 % ）, umbilical factors-torsion, prolapse, shortening （32 % ）, breech presentation （26%）,highrisk PIH（14%）,monstrosity（6%）,placental abruption and placenta praevia（6%）.Conclusion Effective measures of reducing critical asphyxia neonatorum are to strengthen the monitoring of pregnant women and their antenatal care so as to find and treat PIH early and correct breech presentation in time, try to reduce premature delivery,find early and properly treat fetal distress and oafs and prohibit illegal accouchement.