108例新生儿缺氧缺血性脑病诊治分析

Analysis of 108 cases newborn with hypoxic-ischemic encephalopathy

目的探讨新生儿缺氧缺血性脑病的诊治方法,降低病残率及病死率。方法对5年来收治的108例新生儿缺氧缺血性脑病患儿的临床表现、诊治过程及病因以及出院后随访情况进行分析。结果108例患儿中87例存在两种以上的病因,由唯一原因而致病者仅21例。头部影像学显示脑水肿75例,颅内出血34例,其中对90例出院患儿进行了1/2-1年的随访,48例轻度患儿临床及影像学检查均完全恢复,40例中度患儿中完全恢复28例,20例重度患儿中只有5例患儿完全康复,6例死亡,其余均有严重的后遗症且影像学多有脑出血表现。结论新生儿缺氧缺血性脑病的病因复杂,临床表现多样,疾病严重程度及诊治早晚与预后密切相关;在预防、诊断及治疗三个层面早期干预可降低此病的发生率、病残率及病死率。

Objective To explore the diagnosis and treatment of the hypoxic-isehemie eneephalopathy of newborn in improving the healing rate and reducing the morbidity and mortality. Methods All the clinical manifestations, diagnosis and treatment methods, causes and follow-up information were analyzed. Results There were two or more causes in 87 cases,except that 21 cases had only one cause. 75 cases suffered brain edema and 34 cases distressed of intraeranial hemorrhage in the imagination. 90 patients were followed up after discharge, 48 slights and 28 cases of 40 midranges patients recovered very well either in clinical or in imaginations, only 5 patients recovered in the seriousness,6 cases died, the others of serious patients had severe sequelae and intraeranial hemorrhage in the imaginations. Conclusion The causes of hypoxie-isehemie eneephalopathy of newborn were complex and the clinical manifestations were veriform, the prognosis has intimate relations to the degree and commence of diagnosis and treatment. The morbidity , disable rate and mortality would be descended if proper diagnosis and prevention and cure means were given in the early period.