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【目的】探讨影响新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)发病的临床因素和社会因素,为制定干预措施提供参考依据。【方法】使用自拟的调查表对发病组和对照组进行临床流行病学调查,对HIE进行χ2检验和Logistic回归分析。【结果】单因素分析发现与发病有关的因素有性别、居住地、父母职业、父母文化程度、母亲身高等26个(P<0.05)。多因素Logistic回归分析表明:母亲患有贫血、妊娠期高血压综合征(妊高征)、胎盘异常、脐带异常、羊水污染、产程异常的OR值>1、B>0,母亲文化程度、催产素、胎龄的OR值<1、B<0。【结论】羊水污染、妊高征、产程异常、胎盘异常、脐带异常、母亲贫血6个因素为HIE发病的主要危险因素;母亲文化程度高、使用催产素、胎龄正常3个因素为主要保护因素。HIE的发病与产前、产时等临床多因素和社会因素关系密切。
【Objective】 To investigate the clinical and social factors that affect the pathogenesis of neonatal hypoxic-ischemic encephalopathy (HIE) and provide a reference for the development of interventions. 【Methods】 The epidemiological investigation of the disease-onset and control groups was conducted by using a self-designed questionnaire. Chi-square test and Logistic regression analysis were performed on the HIE. 【Results】 The univariate analysis showed that there were 26 factors (sex, place of residence, parental occupation, parental education, mother’s height) associated with the disease (P <0.05). Multivariate Logistic regression analysis showed that the OR of mother with anemia, gestational hypertension (PIH), placental abnormality, umbilical cord abnormality, amniotic fluid contamination and labor abnormalities was> 1, B> 0, mother’s educational level, oxytocin The OR, gestational age OR value <1, B <0. 【Conclusion】 The six factors of amniotic fluid contamination, PIH, labor abnormality, placental abnormality, umbilical cord abnormality and maternal anemia are the main risk factors for HIE. High motherhood, using oxytocin and normal gestational age are the main protective factors factor. The incidence of HIE and prenatal, intercourse and other clinical factors and social factors are closely related.