摘要
目的：探讨新生儿缺血缺氧性脑病（HIE）发生的相关危险因素。方法回顾性分析绍兴市上虞妇幼保健院2008年1月至2013年1月收治的350例HIE患儿临床资料，另选取同期顺产的200例非HIE高危新生儿作为对照组，应用单因素分析和Logistic回归分析筛选HIE发生的相关危险因素。结果多因素Logistic回归显示分娩前因素只有妊娠期糖尿病与HIE相关（RR＝1．43，95％CI：1．08-2．12，P＜0．05），其他HIE独立预测因素均为分娩期因素，即羊水粪染、肩先露、脐带绕颈、产程延长、胎心监护异常、器械助产、急诊剖宫产、1min Apgar＜3分和5min Apgar＜5分（RR值分别为1．97、6．31、2．26、1．84、2．41、1．91、1．21、17．48和20．07，95％CI分别为1．38-3．67、3．44-12．42、1．52-5．20、1．09-4．65、1．14-5．96、1．24-4．77、1．04-2．39、8．21-174．26和7．26-164．28，均P＜0．05）。结论新生儿HIE与母体、胎儿等多种因素相关，其中分娩期是关键，其他因素通过影响分娩期因素起作用。
Objective To investigate the relevant risk factors of hypoxic ischemia encephalopathy （HIE）.Methods Retrospective study was conducted on clinical data of 350 neonates with HIE treated in Maternity and Child Care Hospital of Shangyu District during the period of January 2008 to January 2013.Another 200 neonates without high risk of HIE were selected as control group.Risk factors of HIE were analyzed and screened by single factor analysis and Logistic regression analysis.Results Univariate Logistic analysis showed that only gestational diabetes was correlated with HIE before delivery （RR=1.43,95%CI：1.08 -2.12,P〈0.05）, and that other independent predictive factors were intrapartum complications, including meconium -stained amniotic fluid, shoulder dystocia, tight nuchal cord, prolonged labor, abnormal fetal heart rate, instrumental delivery, emergency cesarean section, 1min Apgar〈3 and 5min Apgar〈5 （ RR value was 1.97, 6.31, 2.26, 1.84, 2.41, 1.91, 1.21, 17.48 and 20.07,95%CI：1.38-3.67, 3.44-12.42, 1.52-5.20, 1.09-4.65,1.14-5.96,1.24-4.77,1.04-2.39,8.21-174.26 and 7.26-164.28, respectively, all P〈0.05）.Conclusion Maternal, fetal and other factors are correlated with neonatal HIE.Delivery is the key, and other factors play a role by influencing intrapartum complications.
出处
《中国妇幼健康研究》
2015年第2期196-198,297,共4页
Chinese Journal of Woman and Child Health Research
