新生儿缺氧缺血性脑病危险因素及相关因素研究

Study of the risk and relatively factors of neonate with hypoxic ischemic encephalopathy

目的 :通过对新生儿缺氧缺血性脑病 (HIE)危险因素及相关因素研究 ,达到早期防治、早期干预的目的。方法 :选择HIE患者 2 13例 ,同时随机选择非HIE患者 6 8例作对照组。从母亲、胎儿、分娩 3个方面 ,列出 2 2个危险因素 ,运用STATISTICA6 0和中国医学百科全书统计软件进行单因素分析及Logistic回归分析。结果 :2 2个变量的单因素分析有 8个因素 (妊娠高血压、胎头吸引器助娩、产程延长、急产、胎粪污染羊水、脐带异常、生后 1minAp gar评分≤ 7分、生后 5minApgar评分≤ 7分 )为危险因素。而把单因素分析有统计学意义的 6个因素 (妊娠高血压、胎头吸引器助娩、产程延长、急产、生后 1minApgar评分≤ 7分、生后 5minApgar评分≤ 7分 )引入Logistic回归模型进行多因素分析则仅有产程延长和生后 1minApgar评分≤ 7分为HIE的危险因素 ,OR分别为 6 5 80 ,110 0 98,95 %CI分别为 1 789～ 2 4 197,0 5 6 9～ 92 938。同时生后 1minApgar评分分别与HIE发病时间、病情严重程度比较差异有显著性 (P <0 0 1)。结论 :单因素分析所提示的危险因素是新生儿窒息的危险因素 ,也是HIE的相关因素 ,而多因素分析所提示的危险因素是HIE的危险因素 ,且与HIE发病时间及病情严重程度密切相关。避免新生儿窒息 ,防治HIE ,?

Aim:To prevent,intervene in and cure HIE early by the research of the risk and relatively factors of HIE.Methods:213 HIE cases were selected and 68 non HIE infants were also selected at the same time as the control group.22 risk factors relevent to mothers,tetus,delivery were listed and analyzed by the methods of single factor analysis and logistic regression analysis which was offered in the software of STATISTICA 6.0 and CHINESE MEDICAL CYCLOPADIA.Results:After Single factor analysis,there were 8 factors(including hypertensive of pregnancy,help delivery by fetal head attrahent appliance,prolonged course of birth,fast birth,meconium like amniotic fluid,umbilic abnormity,postnatal 1 min Apgar grade≤7 mark and postnatal 5 min Apgar grade≤7 mark)proved to be risk factors.However,only prolonged course of birth and postnatal 1 min Apgar grade≤7 mark were risk factors after the six factors(hypertensive of pregnancy,help delivery by fetal head attrahent appliance,prolonged course of birth,fast birth,postnatal 1 min Apgar grade≤7 mark and postnatal 5 min Apgar grade≤7 mark)with statistic meaning were put into logistic recursive analysis model.OR were respectively 6.580,110.098;95% CI were respectively 1.789～24.197,0.569～92.938,and postnatal 1 min Apgar grade had significant difference with the HIE come on time and seriousness of the disease( P <0.01).Conclusion:The risk factors proved by Single factor analysis are the risk factors for the happening of neonatal and also the relevent factors of HIE,while the risk factors proved by many factor analysis are the risk factors of HIE,and they have affinity with HIE come on time and seriousness of the disease,so,avoiding the happening of neonatal preventing and treating HIE,and early intervention are the key steps to reduce the rates of motality and disabitity.