窒息合并肾损伤新生儿的神经预后追踪及意义

Neurological follow-up and its significance in neonates with asphyxia and renal damage

目的:探讨窒息合并肾损伤新生儿的神经预后追踪结果及其临床意义。方法:选择39例窒息新生儿,按是否出现肾功能异常分为窒息组33例、窒息合并肾损伤组6例;同时选取20例单纯肾功能异常的新生儿作为对照组(单纯肾损伤组)。所有患儿在3、6、12月龄时测定头围值、行丹佛智能测评(DDST)。结果:3组患儿生后3、6、12个月头围值和DDST发育商水平比较,差异有统计学意义(均P<0.05);患儿头围发育过程中,时间与肾功能差异存在交互效应(F=0.66;P=0.00),但在发育商水平变化过程中,时间与肾功能差异间无交互效应(F=2.84;P=0.61)。结论:早期评估肾损伤情况,同时加强干预,可改善窒息合并肾损伤患儿神经预后。

Objective： To investigate the significance of neurological follow-up in neonates with asphyxia and renal damage. Methods： Thirty-nine newborns with asphyxia were randomly divided into two groups based on presence of renal damage： simple asphyxia group（ n = 33）,asphyxia and renal damage group（ n = 6）. Twenty neonates with abnormal renal function were recruited as control group. All children underwent measurement of head circumference and the Denver Intelligence Test（ DDST） at 3,6,and 12 months of age. Results： There were significant differences in the head circumference and DDST level between the three groups at 3,6,and 12 months after birth（ all P〈 0. 05）. Significant interaction between time and renal function was found during development of head circumference（ F = 0. 66; P = 0. 00）,but not during the change of development quotient（ F= 2.84,P= 0.61）. Conclusion： Early assessment of renal function and enhanced intervention can improve the neurological outcome in children with asphyxia and renal damage.