54例新生儿缺血缺氧性脑病诊治体会

Diagnosis and Treatment Clinical Experience of 54 cases Neonatal Hypoxic-ischemic Encephalopathy

目的：探讨新生儿缺氧缺血性脑病（HIE）的临床诊断治疗要点。方法：分析2000-2008年我院收治的54例患儿。54例HIE患儿中足月产35例（64.8%）,早产10例（18.5%）,过期产9例（16.7%）。其中轻度：16例,主要表现为兴奋激惹,以24 h内最明显,持续2-3 d即消失;中度：29例,以抑制症状为主,嗜睡、迟钝、哭声弱、肌张力低、原始反射减弱、部分患儿有颅内高压和惊厥;重度：9例。3项支持疗法和2项对症处理是HIE综合治疗中最重要、最根本的措施。结果：54例HIE患儿,治愈36例,好转9例,死亡9例。出院1年对存活的45例患儿进行随访,7例蛛网膜下腔出血患儿痊愈,3例脑实质出血患儿仍不能站立。结论：HIE患儿急需早预防、早诊断、早干预,对提高抢救患儿生命质量有着积极的意义,为HIE患儿搭起一条生命的绿色通道。

Objective：To investigate the hypoxic-ischemic encephalopathy（HIE） in the clinical diagnosis and treatment of the main points.Methods：2000～2008 of the 54 cases treated in our hospital and treatment of children.54 cases of HIE in full-term children with 35 cases（64.8%）,prematurity in 10 cases（18.5%）,expired products in 9 cases（16.7%）.Mild： 16 cases,mainly for the excitement bowel to 24 h of the most significant and sustained 2 ～ 3 days or disappear.Moderate： 29 cases,mainly to suppress the symptoms,lethargy,retardation,weak cry,muscle tension is low,primitive reflexes diminished,some children with intracranial hypertension and seizures.Severe： 9 cases.3 supportive therapy and two symptomatic treatment is the most important and comprehensive treatment of HIE,the most fundamental measures.Results：54 cases of HIE children,cured 36 cases,improvement in 9 cases and 9 died.Discharged from hospital a year on the survival of the 45 cases were followedup children,seven cases of subarachnoid hemorrhage in children with cured,3 cases of cerebral hemorrhage in children still can not stand.Conclusion： HIE children need early prevention,early diagnosis,early intervention,improving the quality of life to save children has a positive significance,for children with HIE erected a life-green channel.