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探讨窒息婴儿复苏后哪些症状是早期诊断的主要依据、何时可诊断新生儿缺氧缺血性脑病(IHE)等,对305名窒婴儿生后30 min、3 h、6 h、12 h、24 h、72 h动态观察18项神经症状在各时段的变化。应用SPSS10.0统计学软件进行统计学处理,率的差异性比较应用r2检验;相关性分析应用直线相关分式计算关联系数r值。结果显示观察至72 h,55名诊断为HIE;生后30 min内的HIE患儿兴奋激惹发生率达62％,上、下肌张力减弱和原始反射减弱见于60％患儿,并持续至72 h及以后。窒息儿生后仅10％发生兴奋激惹,12 h消失,肢体肌张力减弱12 h后接近消失。因此,窒息儿生后出现兴奋激惹,3～6 h加重或转为抑制,并伴有肢体肌张力减弱和拥抱、握持反射减弱,便可考虑诊断早期HIE。
To investigate the symptoms of asphyxia in infants after resuscitation which is the main basis for the early diagnosis, when can diagnose neonatal hypoxic-ischemic encephalopathy (IHE), 305 infants after birth, 30 min, 3 h, 6 h, 12 h, 24 h, 72 h dynamic observation of 18 neurological symptoms in each period of change. SPSS10.0 statistical software was used for statistical analysis, the rate of difference was compared using r2 test; correlation analysis using linear correlation fractional correlation coefficient r value. The results showed that at 72 h, 55 were diagnosed as HIE. The incidence of excitement in children with HIE within 30 min after birth was 62%. The tension of the upper and lower muscles was weakened and the reflex of the original reflex was found in 60% of the infants and continued until 72 h and beyond. After asphyxia, only 10% of children were excited and provoked, 12 h disappeared, limb muscle tension weakened after 12 h and disappeared. Therefore, asphyxia excited after excitement, 3 to 6 h exacerbated or converted to inhibition, and accompanied by weakening of the limb muscle tension and embrace, hold down the reflex, you can consider the diagnosis of early HIE.