新生儿重度缺氧缺血性脑病预后因素临床分析

Clinical analysis of the prognostic factors of neonatal severe hypoxic ischemic encephalopathy

目的 探讨新生儿重度缺氧缺血性脑病的预后因素。方法 2011年1月至2014年12月湖南省儿童医院新生儿科收治住院的重度新生儿缺氧缺血性脑病患儿131例,对其预后影响因素进行相关和回归分析。结果 单因素分析显示5min Apgar评分、惊厥、昏迷、pH值、剩余碱值、脏器损伤是影响重度新生儿缺氧缺血性脑病预后的危险因素;多因素Logistic分析结果表明,5 min Apgar评分〈3分（OR=4.256,95%CI1.501~15.432）、剩余碱≤-10mmol/L（OR=37.208,95%CI6.053~42.105）是影响重度新生儿缺氧缺血性脑病预后的独立性危险因素（P〈0.05）,入院日龄〈72h（OR=0.098,95%CI 0.032~0.367）是重度新生儿缺氧缺血性脑病保护因素。结论 影响重度新生儿缺氧缺血性脑病预后的因素很多,及时发现这些因素,是预防重度新生儿缺氧缺血性脑病的关键所在,临床医师应该引起重视和早期干预。

Objective To investigate the prognostic factors of neonatal severe hypoxic ischemic en-cephalopathy.Methods A total of 131 cases of HIE neonates were admitted and treated in Children＇s Hospi-tal of Hunan Province from Jan.2011 to Dec.2014,and a regression analysis was make on the prognostic factors.Results Single factor analysis showed that 5 min Apgar score,convulsions,coma,pH value,BE val-ue and organ damage were the prognostic risk factors of severe HIE in neonates.Multi-factor Logistic analy-sis showed that the 5 min Apgar score less than 3（OR =4.256,95%CI 1.501 ~ 15.432）and BE value no more than -10 mmol/L（OR=37.208,95%CI 6.053~42.105）were the independent prognostic rick fac-tors of severe HIE （P〈0.05）;the hospital stay shorter than 72 h（OR=0.098,95%CI 0.032~0.367）was the protective factor of severe HIE in neonates.Conclusion There are many factors that influence the prog-nosis of severe HIE in neonates.It is the key to the preventing severe neonatal HIE to find these factors as early as possible,so clinical physicians should pay attention to it and perform early intervention.