新生儿缺氧缺血性脑病临床分析

Clinical Analysis Neonates with Hypoxic Ischemic Encephalopathy

目的 :探讨新生儿缺氧缺血性脑病 (HIE)的主要致病因素、合并症、治疗及转归。方法 :收集本院出生的 6 1例新生儿HIE临床资料 ,以百分率法作统计分析。结果 :6 1例新生儿HIE :原因 :脐带因素占 4 0 % ,胎位不正 2 1%。新生儿HIE合并症中吸入性肺炎 (MAS) 70 % ,肾脏受损 4 0 %、颅内出血 2 8%、消化系统受损 2 5 %、心肌受损 2 1%。早产儿易合并坏死性小肠结肠炎 (NEC)和呼吸窘迫综合症 (RDS)。在综合治疗的基础上 ,另加纳络酮与脑活素联合治疗 ,治愈 5 3例 (87% ) ,无效 5例 (8% ) ,死亡 3例 (5 % )。结论 :新生儿HIE多发生于足月儿 ;致病因素以脐带和围生期因素为主 ;新生儿HIE易合并多器官受损或衰竭 ,其中以肺、肾、肠、心等脏器受损较多 ;

Objective: To explore the etiology,complications, treatment,and prognosis of hypoxic ischemic encephalopathy (HIE) in neonates.Methods:Collecting the clinical information of 61 neonates with HIE;the statistical analysis was performed on the clinical information by the percentage method.Results:Among the 61 neonates with HIE the causes of hypoxia and ischemia were the abnormality of umbilical cord (40%) mainly and the abnormality of fetal position (21%);The complications of HIE were meconium aspiration syndrome(MAS)(70%),then renal dysfunction (40%),intracranial hemorrhage (28%), digestive system dysfunction (25%),and heart dysfunction (21%).Premature infants were susceptible to developing narcotizing enterocolitis (NEC) and respiratory distress syndrome (RDS). By treating the neonates with HIE by naloxone and cerebrolysin, 53(87%) of all cases were healed, 5(8%) were not effective and 3(5%) were dead. Conclusion: HIE often develops in full term newborn infants. The etiologies of HIE are abnormality of umbilical cord and abnormality of fetal position mainly. Neonates with HIE are susceptible to develop multiple organ dysfunction syndrome.Complications of HIE are dysfunction of the lungs, kidneys, intestines, and heart, as well as intracanial hemorrhage.Treating the neonates with HIE with naloxone and cerebrolysin can raise clinical therapeutic effect.