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【medical-news】窒息新生儿罹患新生儿缺血缺氧性
Risk factors for hypoxic-ischemic encephalopathy in asphyxiated newborn infants
摘要
OBJECTIVE: To determine the risk factors for hypoxic-ischemic encephalopathy (HIE) in asphyxiated newborn infants. MATERIAL AND METHOD: A retrospective study of 17,706 newborns, who were admitted to the Neonatal Unit of King Chulalongkorn Memorial Hospital, from July 1999 till the end of December 2000. 84 infants with perinatal asphyxia were enrolled in the present study. All of the possible risk factors that might have contributed to asphyxia were identified and recorded HIE was diagnosed based on the Modified Sarnat-Sarnat Score for the diagnosis of neonatal encephalopathy. The clinical data of the HIE group were compared with those of the HIE negative group. The categorical data were analyzed for statistical significance (p < 0.05) by Chi-square test or Fisher exact test, or Student t-test. The odds ratio and 95% CI were calculated for those with statistical significance. Stepwise multiple logistic regression analysis used to determine the independent factors that may predispose an infant to HIE. RESULTS: Inappropriate antenatal care (OR 9.4; 95%CI: 2.6-35.4), post-term gestation (OR 7.4; 95%CI: 1.4-34.8), vacuum extraction (OR 5.4; 95%CI: 1.1-26.8), male (OR 4.8; 95%CI: 1.3-19.1), prolapsed cord (p = 0.01) and 1 and 5-minute Apgar scores, (p < 0.0001) were significant risk factors for HIE. However, by multiple regression analysis, only a 5-minute Apgar score was significantly associated with HIE (p = 0.001). CONCLUSION: Sophisticated or expensive equipment is not necessary for the treatment of HIE patient. HIE depends mainly on adequate and effective supportive strategy. The delivery of high risk pregnancies, under obstetric facilities and with appropriate intervention and with good neonatal resuscitation, may prevent the perinatal asphyxia and thereby minimize the occurring of HIE. Risk factors for hypoxic-ischemic encephalopathy in asphyxiated newborn infants
窒息新生儿罹患新生儿缺血缺氧性脑病的危险因素
OBJECTIVE: To determine the risk factors for hypoxic-ischemic encephalopathy (HIE) in asphyxiated newborn infants.
目标：确定窒息新生儿罹患新生儿缺血缺氧性脑病(HIE)的危险因素。
MATERIAL AND METHOD: A retrospective study of 17,706 newborns, who were admitted to the Neonatal Unit of King Chulalongkorn Memorial Hospital, from July 1999 till the end of December 2000. 84 infants with perinatal asphyxia were enrolled in the present study. All of the possible risk factors that might have contributed to asphyxia were identified and recorded HIE was diagnosed based on the Modified Sarnat-Sarnat Score for the diagnosis of neonatal encephalopathy. The clinical data of the HIE group were compared with those of the HIE negative group. The categorical data were analyzed for statistical significance (p < 0.05) by Chi-square test or Fisher exact test, or Student t-test. The odds ratio and 95% CI were calculated for those with statistical significance. Stepwise multiple logistic regression analysis used to determine the independent factors that may predispose an infant to HIE.
材料与方法：对皇家朱拉隆功医院婴儿室从1999年7月到2000年12月末收入的17706例新生儿进行回顾性研究。在目前的研究中已有84位窒息新生儿登记在册。所有可能导致窒息的危险因素都被拿来鉴定，而且已记录在案的HIE都是基于对新生儿窒息的改良Sarnat-Sarnat评分确诊的。HIE组与非HIE组的临床数据相对比。用卡方检验、t检验或Fisher’s确切概率法来检验聚类的统计学意义(p < 0.05)，算出有统计学意义的聚类的可能性比率（OR）和95% 置信区间（95% CI）。使用多元逐步Logistic回归分析来确定可能会诱发新生儿罹患HIE的独立因素。
RESULTS: Inappropriate antenatal care (OR 9.4; 95%CI: 2.6-35.4), post-term gestation (OR 7.4; 95%CI: 1.4-34.8), vacuum extraction (OR 5.4; 95%CI: 1.1-26.8), male (OR 4.8; 95%CI: 1.3-19.1), prolapsed cord (p = 0.01) and 1 and 5-minute Apgar scores, (p < 0.0001) were significant risk factors for HIE. However, by multiple regression analysis, only a 5-minute Apgar score was significantly associated with HIE (p = 0.001).
结果：不恰当的产前护理(OR 9.4; 95% CI: 2.6-35.4)，过期妊娠(OR 7.4; 95%CI: 1.4-34.8)，胎头吸引术(OR 5.4; 95%CI: 1.1-26.8)，男性(OR 4.8; 95%CI: 1.3-19.1)，脐带脱出(p = 0.01)以及Apgar 评分1分、5分(p < 0.0001)，是HIE的高危因素。然而，经过多元回归分析，只有Apgar 评分5分与HIE有意义重大的联系(p = 0.001)。
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作者:admin@医学,生命科学 2011-04-29 17:11
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