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目的探讨可能导致新生儿缺血缺氧性脑病(HIE)的产科高危因素及预防措施。方法回顾分析2000年1月-2012年11月在介休市计划生育妇幼保健服务中心出生的26例新生儿缺血缺氧性脑病患儿,均因客观原因未进行产科产前干预。对照组为随机抽取同期经过应用硫酸镁、糖皮质激素及吸氧等进行产科产前干预的26例高危孕妇并剖宫产分娩的新生儿,分析两组的相关产科因素。结果观察组孕周、出生体重轻、生物物理评分、胎儿血氧饱和度低、脐血流(S/D)高、新生儿Apgar评分(在1min和5minApgar评分低)与HIE相关;与对照组相比差异有统计学意义(P<0.05)。结论新生儿缺血缺氧性脑病发生大部分与胎龄、出生体重及产前宫内胎儿窘迫有关,对一些有相关产科高危因素的孕妇通过应用硫酸镁、糖皮质激素及吸氧等采取干预措施,可以降低新生儿缺血缺氧性脑病的发生,最大程度减少脑瘫发生和残疾程度,提高出生人口素质。
Objective To explore the obstetric risk factors and preventive measures that may lead to neonatal hypoxic ischemic encephalopathy (HIE). Methods A retrospective analysis was conducted on 26 neonates with hypoxic-ischemic encephalopathy who were born at the Family Planning MCH center in Jiexiu from January 2000 to November 2012. All of them were obstetric prenatal interventions due to objective reasons. The control group was randomly selected 26 cases of high-risk pregnant women and cesarean delivery of newborns during the same period after the application of magnesium sulfate, glucocorticoid and oxygen for obstetric prenatal interventions, the relevant obstetric factors were analyzed. Results The gestational age, birth weight, biophysical score, low fetal oxygen saturation, high umbilical blood flow (S / D), neonatal Apgar score (low Apgar scores at 1 and 5 min) were associated with HIE; Compared with the difference was statistically significant (P <0.05). Conclusion The majority of neonatal hypoxic-ischemic encephalopathy is related to gestational age, birth weight and prenatal intrauterine fetal distress. Some pregnant women with related obstetric risk factors through the application of magnesium sulfate, glucocorticoid and oxygen intervention Measures can reduce the incidence of neonatal hypoxic ischemic encephalopathy, to minimize the incidence and disability of cerebral palsy, improve the quality of the birth population.