窒息新生儿缺氧缺血性脑病相关因素分析

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Abstract Objective To study the difference of clinical and laboratory findings between children with moderate and severe hypoxic-ischemic encephalopathy (HIE) and those with non-moderate-severe HIE in order to remind clinicians of early detection of moderate-severe HIE in infants and interventions.Methods The clinical data on eighty cases of asphyxia treated in our department between January 1, 2013 and December 31, 2014 was retrospectively analyzed.These patients were divided into non-moderate-severe HIE group and moderate-severe HIE group. Clinical factors and laboratory results were compared between the two groups. SPSS 17.0 software was used for statistical analysis, and P<0.05 was considered statistically significant.Results Seventy-two cases were enrolled, fourteen with moderate-severe HIE, and fifty-eight with non-moderate-severe HIE. (1) Apgar scores at 1 minute, 5 minutes and 10 minutes after birth, arterial blood gas analysis at 1 hour after birth, PH, BE and HCO-3 concentrations in both groups were significantly different between the two groups(P<0.05), but not in partial pressure of oxygen PO₂)or partial pressure of carbon dioxide (PCO₂) (P>0.05). (2) The incidence of seizures, the abnormal rate of amplitude integrated electroencephalogram (aEEG) within 3 days after birth and abnormal blood glucose, renal dysfunction, abnormal myocardial enzymes, incidence of abnormal digestive tracts, the proportion of patients in need of mechanical ventilation were higher in the moderate-severe HIE group than in the non-moderate-severe HIE group (P<0.05). (3) Alanine aminotransferase (ALT), aspartate aminotransferase (AST), prealbumin, total bilirubin, direct bilirubin, and total bile acids were not significantly different between the two groups 12-24 hours after birth (P> 0.05).Conclusions Low Apgar scores, severe acidosis suggested by arterial blood gas about 1h after birth, and complications with multiple organ dysfunction indicate that moderate to severe HIE may occur in children with asphyxia. Enzymatic liver indicators and indicators of reaction cholestasis are not closely correlated with moderate and severe HIE.

Key words： neonatal asphyxia hypoxic-ischemic encephalopathy multiple organ damage prognosis

Received: 29 June 2017

ZTFLH:

R722.12

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	GUO Guo
	ZHANG Xuefeng

Cite this article:

GUO Guo,ZHANG Xuefeng. Related factors of hypoxic ischemic encephalopathy in newborns with asphyxia[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(4): 374-377.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2018/V29/I4/374

[1]	Aslam H M, Saleem S, Afzal R, et al. Risk factors of birth asphyxia[J]. Italian Journal of Pediatrics, 2014, 40(94):1-9.
[2]	李扬方, 胡玫, 潘晓洁,等. 新生儿缺氧缺血性脑病预后分析[J]. 中华围产医学杂志, 2000, 3(3): 166 - 168.
[3]	周丛乐, 汤泽中, 侯新琳. 新生儿神经病学[M]. 北京:人民卫生出版社,2012:255.
[4]	Use and abuse of the Apgar score. Committee on Fetus and New born, American Academy of Pediatrics, and Committee on Obstetric Practice, American College of Obstetricians and Gynecologists[J]. Pediatrics, 1996, 98(1):141 - 142.
[5]	中国医师协会新生儿专业委员会. 新生儿窒息诊断和分度标准建议[J]. 中国当代儿科杂志, 2013, 15(1): 1.
[6]	杨洁, 朱建幸. Apgar评分对新生儿窒息诊断价值的再评价[J]. 中华围产医学杂志, 2014, 17(11): 721-723.
[7]	秦山红,马存丽,罗佳. 脐动脉血气对新生儿窒息及预后判断的临床意义[J]. 云南医药, 2014, 35(1): 13-16.
[8]	Perlman J M.Interruption of placental blood flow during labor: potential systemic and cerebral organ consequences[J]. J Pediatr, 2011, 158: e1-4.
[9]	Periman J M. Intervention strategies for neonatal hypoxic-ischemic cerebral injury[J]. Clin Ther, 2006, 28(9): 1353-1365.
[10]	戈梅勒. 新生儿学手册( 国外医学经典手册系列) [M].5 版.长沙: 湖南科学技术出版社, 2006:590.
[11]	Bhatti A, Kumar P. Systemic effects of perinatal asphyxia[J]. Indian J Pediatr, 2014, 81(3): 231-233.
[12]	Shah P, Riphagen S, Beyene J, et al. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy[J]. Arch Dis Child Fetal Neonatal Ed,2004, 89(2): F152-155.
[13]	Chhavi N,Zutshi K,Singh N K.Serum liver enzyme pattern in birth asphyxia associated liver injury[J].Pediatr Gastroenterol Hepatol Nutr,2014,17(3):162-169.
[14]	储微, 温晓红. 振幅整合脑电图在监测新生儿窒息中的应用[J]. 中国儿童保健杂志,2011, 19(11): 1008-1010.
[15]	程国强, 施亿赘, 邵肖梅, 等. 振幅整合脑电图评分系统评价新生儿脑发育的临床价值[J]. 中华围产医学杂志, 2012, 15(4): 234-237.
[16]	程国强, 陈丽霞, 邵肖梅. 振幅整合脑电图预测足月儿缺氧缺血性脑病预后的mate分析[J]. 中华围产医学杂志, 2011, 14(11): 653-659.