摘要目的 分析新生儿脑病构成和相关危险因素,探讨降低新生儿脑损伤发生的措施.方法 选择3年内新生儿脑病患儿300例,对相关病因及高危因素进行分析.结果 入组的300例新生儿脑病中缺氧缺血性脑病(HIE)的比例仅为37.3％,导致新生儿脑病的原因还包括颅内出血、颅内感染、先天性遗传代谢性疾病、胆红素脑病等;单因素分析示胎儿宫内窘迫、胎盘异常、脐带异常、胎膜早破、围生期感染、败血症、难产等与新生儿缺氧缺血性脑病的发生有关,而产时的急性缺氧事件并非均导致缺氧缺血性脑病的发生.结论 新生儿脑病的构成包括缺氧缺血性脑病、颅内出血、颅内感染、先天性遗传性代谢病、胆红素脑病、染色体病、脑梗死、低血糖脑病、主要解剖异常等,而新生儿缺氧缺血性脑病与多种围生期的高危因素有关,因此不能把多数新生儿脑病的病因简单地归为产时的急性缺氧事件.

abstractsObjective To analyze the constitution and related risk factors of neonatal encephalopathy,and investigate the effective measures of reducing the occurrence of neonatal brain damage.Methods The clinical data of 300 cases of neonatal encephalopathy from January 2010 to December 2012 were retrospectively analyzed,the etioloaic factor and high risk factors of neonatal encephalopathy during the past three years were analyzed.Results Among the 300 cases of neonatal encephalopathy,hypoxic ischemic encephalopathy accounting for 37.3％,and the other risk factors of neonatal encephalopathy including intracranial hemorrhage,intracranial infection,congenital inherited metabolic diseases,bilirubin encephalopathy,and so on.Single factor analysis indicated that the following factors were associated with the development of neonatal hypoxic ischemic encephalopathy,including fetal distress in uterus,placenta,abnormality of umbilial cord,premature rupture of membranes,perinatal infection,septicemia and dystocia' etc.The acute anoxic events during production didn' t all lead to the occurrence of hypoxic ischemic encephalopathy.Conclusions The neonatal encephalopathy consists of hypoxic ischemic encephalopathy,intracranial hemorrhage,intracranial infection,congenital inherited metabolic diseases,bilirubin encephalopathy,chromosome disease,cerebral infarction,hypoglycemic encephalopathy,the main anatomical abnormalities,and neonatal hypoxic ischemic encephalopathy was related to many perinatal high-risk factors,therefore,the etiology of neonatal encephalopathy cannot simply be attributed to intrapartum acute hypoxic events.