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目的回顾性分析我院170例新生儿重度窒息的临床情况及各脏器受累损伤程度,了解与死亡有关的危险因素。方法对1993～2004年我院NICU收治的重度窒息新生儿170例资料进行分析,用SAS软件对与死亡有关危险因素进行OR分析。结果170例中死亡22例(12.5%),165例(97.1%)出现各脏器的并发症,各脏器受累机会的次序依次为中枢神经系统,肺,代谢系统等;严重程度依次为代谢,肺,中枢神经系统等。与死亡有关的危险因素依次为中枢神经系统严重受累,1个以上脏器严重受损,呼吸衰竭,代谢紊乱,电解质紊乱,血气异常,肺损害,10分钟Apgar评分≤3,胎龄<37周,肝脏损害,心脏损害,PCO2增高和血液系统损伤。结论器官/系统损害是除HIE外新生儿重度窒息的主要并发症,严重威胁生命并且可以导致死亡;对于一些造成死亡的危险因素应该引起重视和早期干预。
Objective To retrospectively analyze the clinical condition of 170 newborns with severe asphyxia in our hospital and the degree of injury involved in each organ and to understand the risk factors associated with death. Methods The data of 170 newborns with severe asphyxia admitted to NICU from 1993 to 2004 in our hospital were analyzed. The risk factors associated with death were analyzed by SAS software. Results Of 170 cases, 22 cases died (12.5%) and 165 cases (97.1%) had organ complications. The order of organ involvement was central nervous system, lung, metabolic system and so on. The severity was metabolic , Lung, central nervous system and the like. The risk factors associated with death were followed by severe central nervous system involvement, severely impaired one or more organs, respiratory failure, metabolic disorders, electrolyte imbalance, abnormal blood gas, lung damage, Apgar score at 10 minutes ≤3, gestational age <37 weeks , Liver damage, heart damage, increased PCO2 and blood system damage. Conclusions Organ / systemic injury is a major complication of severe asphyxia in newborns other than HIE, which is a serious life-threatening and can result in death; some of the risk factors for death should be given priority and early intervention.