新生儿缺氧缺血性脑病的发病、预后与围产因素的关系

Relationships between pathogenesis,prognosis and perinatal factors of neonatal hypoxic-ischemic encephalopathy

目的:探讨新生儿缺氧缺血性脑病(HIE)的发病、预后与各种围产因素的关系。方法:对我院新生儿重症监护病房2012年7月至2017年6月收治的187例HIE临床资料进行回顾性分析。结果:5年间我院产科出生新生儿HIE检出率1. 12%,HIE病死率19. 79%。62例轻度HIE无死亡,43例中度HIE死亡3例,82例重度HIE死亡34例,重度HIE病死率41. 46%。围产因素中孕母因素29例死亡3例,胎盘因素24例死亡3例,脐带因素70例死亡22例,难产因素46例死亡7例,新生儿因素18例死亡2例,以脐带因素的病死率31. 43%(22/70)为最高。结论:HIE病死率高,其发病的围产因素中以脐带因素为多见和严重,对存在围产高危因素的孕产妇要加强监护,针对防止新生儿窒息采取有效措施。

Objective:To explore the relationships between pathogenesis,prognosis and perinatal factors of neonatal hypoxic-ischemic encephalopathy(HIE).Methods:Clinical data of 187 cases of HIE admitted to neonatal intensive care unit in our hospital from July 2012 to June 2017 was retrospectively analyzed.Results:During the 5 years,the detection rate of HIE born in our obstetrics was 1.12%,the fatality rate of HIE was 19.79%.According to clinical grading,none of 62 mild HIE cases was dead,3 of 43 moderate HIE cases were dead,34 of 82 severe HIE cases were dead,and the fatality rate of severe HIE was 41.46%.As to perinatal factors,3 of 29 cases of maternal factors were dead,3 of 24 cases of placental factors were dead,22 of 70 cases of umbilical cord factors were dead,7 of 46 cases dystocia factors were dead,and 2 of 18 cases of neonatal factors were dead.The fatality rate of umbilical cord factor was 31.43%(22/70),which was the highest.Conclusion:The fatality rate of HIE is high.Umbilical cord is the most common and serious perinatal factor.The pregnant and lying-in women with high perinatal risk factors should be monitored and effective measures should be taken to prevent neonatal asphyxia.