宫内缺氧致新生儿缺氧缺血性脑病Apgar评分与病情预后的关系

Apgar Scores of Neonatal Hypoxic Ischemic Encephalopathy Caused by Intrauterine Hypoxia and the Relations with Pathology and Prognosis

目的：研究宫内缺氧致新生儿缺氧缺血性脑病（hypoxic-ischemicenc ephalopathy，HIE）出生后Apgar评分与病情预后的关系。方法：选择我院2001年1月～2006年5月收治的210例宫内缺氧致HIE的临床及随访资料进行分析。结果：210例中出生后1分钟内Apgar评分1～3分54例，4—7分141例，8～10分15例。随访时间（10．6±3．7）个月。Apgar评分1～3分组出现神经系统后遗症3例，死亡3例，放弃治疗2例，侧脑室扩大3例；4～7分组出现语言功能障碍1例，硬膜下积液2例；8～10分组出现脑瘫、第三脑室扩大、侧脑室扩大各1例。结论：胎儿有宫内缺氧时出生后可能患HIE，出生后1分钟内Apgar评分1～3分的患儿预后较差，但即使Apgar评分正常，也有可能出现神经系统严重后遗症。

Objective：To analyze the relationship of Apgar scoring after birth with the follow-up results of newborn infants with HIE caused by intrauterine asphyxia. Methods：Clinical data and follow-up data of 210 cases of newborn infants with HIE caused by intrauterine asphyxia from January 2001 to May 2006 were collected and analyzed. Results：54 cases were graded 1-3 within 1 minute after birth according to Apgar scores, 141 cases were graded 4-7 and 15 cases were graded 8-10. The average follow-up time was （ 10.6 ± 3.7） months ,3 of the 54 cases with Apgar scores of 1-3 at birth showed nervous system sequelae, Including 3 deaths, 2 cases gave up treatment and 3 cases showed dilated lateral ventricle. Of the 141 cases with Apgar scores of 4-7 at birth,1 case showed language dysfunction and 2 cases showed subdural effusion. Of the 15 cases with Apgar scores of 8-10 at birth, 1 case got cerebral palsy, 1 case got dilated 3 rd ventricle and 1 case of dilated lateral ventricle. Conclusion：Newborn infants,who have experienced intrauterine asphyxia,might suffer from HIE and dont seem to get good recovery within Ⅰ minute after birth. Even infants with normal Apgar scores might also be affected in nervous system and suffer from severe sequelae.