张金燕;王晨阳;郭晓丽;李军歌;苏元元;

• 1:郑州大学第三附属医院

摘要(Abstract)：

目的联合围生期因素及新生儿期因素探讨新生儿缺氧缺血性脑病短期预后不良的相关因素。方法回顾2016-11—2020-04在郑州大学第三附属医院分娩并入住新生儿科治疗的缺氧缺血性脑病活产新生儿的临床资料,根据最终结局分为预后良好组及预后不良组。比较2组患儿母亲围生期因素及新生儿期相关因素,组间采用χ²检验及Spearman方法进行因素相关性分析,多因素Logistics回归分析处理影响HIE新生儿短期预后不良的独立因素。结果 166例缺氧缺血性脑病新生儿中,预后不良29例(17.47%),不同组间羊水量、胎膜早破情况、脐带情况、羊水性质、孕期并发症、定期围生保健情况、保胎史、胎龄、出生体质量、Apgar 1 min评分、Apgar 5 min评分、BE值、pH值、新生儿呼吸窘迫综合征分级、呼吸暂停、新生儿窒息、新生儿呼吸衰竭、新生酸中毒预后不良率均有差异(P<0.05)。Logistic回归分析显示,胎膜早破、Apgar 1 min评分、Apgar 5 min评分,呼吸暂停情况、pH值均是影响新生儿缺氧缺血性脑病短期预后不良的独立因素(P<0.05),定期围生保健是预后不良的保护性因素。在预后不良组中,对围生期因素和新生儿期因素进行相关性分析,共有5对因素存在相关性,分别是羊水性质-新生儿体质量、脐带情况-新生儿窒息、胎膜早破情况-呼吸暂停情况、胎膜早破情况-新生儿呼吸窘迫综合征分级、胎膜早破情况-Apgar 1 min评分。结论新生儿缺氧缺血性脑病短期预后不良的影响因素较多,应及早从母亲围生期和新生儿期双方面给予高度关注和干预,以降低新生儿缺氧缺血性脑病短期预后不良率。

关键词(KeyWords)： 新生儿;缺氧缺血性脑病;预后不良;母婴

Abstract:

Keywords:

基金项目(Foundation): 河南省科技厅项目(编号:182102310394)

作者(Authors): 张金燕;王晨阳;郭晓丽;李军歌;苏元元;

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