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新生儿缺氧缺血性脑病(HIE)是指在围产期窒息导致脑的缺氧缺血性损害,临床出现一系列脑病的表现.为了提高对本病的认识,拟订HIE临床诊断依据及分度(附表),供临床参考。1 临床诊断依据1.1 具有明确的围产期缺氧史,特别是围产期重度窒息(Apgar评分1分钟<3分,5分钟<6分,经抢救10分钟后始有自主呼吸或需用气管内插管正压呼吸2分钟以上者)。1.2 生后12小时内出现以下异常神经症状:意识障碍,如过度兴奋(肢体颤抖,睁眼时间长,凝视等)、嗜睡、昏睡甚至昏迷;肢体肌张力改变,如张力减弱、松软;原始反射异常,如拥抱反射过分活跃、减弱或消失,吸吮反射减弱或消失。1.3 病情较重时可有惊厥.应注意新生儿惊厥特点,如面部、肢体不规则、不固定的节律性抽动,眼球凝视、震颤伴有呼吸暂停.面色青紫.
Neonatal hypoxic-ischemic encephalopathy (HIE) refers to the hypoxic-ischemic brain damage caused by perinatal asphyxia, clinical manifestations of a series of encephalopathy.To improve the understanding of the disease, the preparation of clinical diagnosis of HIE and Index (Schedule) for clinical reference. 1 clinical diagnosis based on 1.1 have a clear history of perinatal hypoxia, especially perinatal severe asphyxia (Apgar score 1 minute <3 minutes, 5 minutes <6 minutes, after rescued 10 minutes after spontaneous breathing or tracheal need Intubation positive pressure breathing more than 2 minutes). 1.2 within 12 hours after birth, the following abnormal neurological symptoms: unconsciousness, such as over-excitement (limb tremor, long time to open eyes, gaze, etc.), drowsiness, lethargy and even coma; limb muscle tone changes, such as tension weakened, Abnormalities, such as embracing reflex hyperactivity, weaken or disappear, sucking reflex diminish or disappear. 1.3 when the condition may be heavier convulsions. Should pay attention to newborns convulsions characteristics, such as the face, irregular limbs, irregular fixed rhythms, eye gaze, tremor accompanied by apnea.