不同胎龄围生期窒息与多器官功能损伤的相关性  

Correlation between multiorgan damage and perinatal asphyxia occurred at different gestational ages

作　　者：仇杰[1] 臧丽娇 庄根苗 安丽[2] 

机构地区：[1]泰山医学院研究生院,山东泰安271016 [2]山东大学附属济南市中心医院儿科,山东济南250013

出　　处：《山东大学学报（医学版）》2016年第9期64-68,共5页Journal of Shandong University:Health Sciences

基　　金：山东省科技发展计划(2013GSF11868)

摘　　要：目的探讨不同胎龄围生期窒息与多器官功能损伤（MODS）的相关性。方法收集山东大学附属济南市中心医院产科有窒息高危因素的新生儿165例,根据脐动脉血气分析结果及Apgar评分判断有无围生期窒息,将其分为早产窒息组、足月窒息组、早产对照组、足月对照组,比较各组MODS的发生率。165例中发生围生期窒息的新生儿有79例,根据胎龄将其分为早期早产窒息组、晚期早产窒息组、足月窒息组,比较各组窒息后MODS的严重程度;根据窒息程度分为轻度窒息组、重度窒息组,比较两组MODS的发生率及严重程度。结果早产窒息组MODS发生率高于足月儿窒息组（χ2=5.37,P〈0.05）。窒息后MODS严重程度：早期早产窒息组、晚期早产窒息组、足月窒息组比较差异有统计学意义（χ2=6.11,P〈0.05）,胎龄与M ODS的发生率呈正相关性（r=0.29）,胎龄与窒息后MODS程度呈正相关性（r=0.35）;轻度窒息组与重度窒息组MODS发生率差异有统计学意义（χ2=9.30,P〈0.05）,轻度窒息组与重度窒息组MODS严重程度差异有统计学意义（χ2=6.80,P〈0.05）。结论早产儿围生期窒息后发生MODS的风险高于足月儿;胎龄越小,窒息后MODS的发生率越高、程度越重;围生期窒息越重,MODS的发生率越高、程度越严重。Objective To study the relationship between multiorgan damage and perinatal asphyxia occurred at different gestational ages. Methods A total of 165 cases born in the Obstetrics Department of Jinan Central Hospital who had risks of neonatal asphyxia were collected. According to the results of umbilical arterial blood gas analysis and Apgar score, these neonates were divided into the premature asphyxia group, full-term asphyxia group, premature control group mad full-term control group. The incidence of MODS was compared. The 79 cases of perinatal asphyxia were di- vided into early premature asphyxia group, late premature asphyxia group and full-term asphyxia group according to gestational ages. The severity of MODS was compared. Then the 79 cases of perinatal asphyxia were divided into mild asphyxia group and severe asphyxia group according to the degree of asphyxia, and the severity of MODS in the two groups was compared. Results The incidence of MODS was higher in the premature asphyxia group than in the fullterm asphyxia group, with statistically significant difference （X2 = 5.37, P 〈 0.05 ）. The severity of MODS following perinatal asphyxia was highest in the early premature asphyxia group, followed by late premature asphyxia group, and full-term asphyxia group, with statistically significant difference （X2 = 6. 11, P 〈 0.05 ）. There was correlation between the incidence of MODS and gestational age （ r = 0.29 ）, and the degree of MODS and gestational age （ r = 0.35 ）. There was statistical difference in the incidence of MODS, and severity of MODS between mild and severe asphyxia groups （X2 = 9.30, P 〈 0.05 ）, （X2 = 6.80, P 〈 0.05 ）. Conclusion Preterm infants have higher risk of MODS after perinatal asphyxia than term infants. Smaller gestational age is correlated to higher incidence and severity of MODS And the severity of perinatal asphyxia is positively correlated to the incidence and severity of MODS.

关 键 词：多器官功能损伤 围生期窒息 早产儿 足月儿 

分 类 号：R722[医药卫生—儿科]