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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(χ~2=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(χ~2=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(χ~2=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(χ~2=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 investigate the relationship between perinatal asphyxia and multiple organ dysfunction (MODS) at different gestational ages. Methods 165 neonates with high risk of asphyxia were collected from Department of Obstetrics, Jinan Central Hospital Affiliated to Shandong University. According to the result of umbilical arterial blood gas analysis and Apgar score, whether there was perinatal asphyxia was divided into premature asphyxia group, full-term asphyxia group, Preterm birth control group, term control group, compared the incidence of MODS in each group. Among 165 neonates with perinatal asphyxia, 79 cases were divided into early preterm asphyxia group, late preterm asphyxia group and full-term asphyxia group according to gestational age. The severity of MODS after asphyxia in each group was compared. According to the degree of asphyxia Divided into mild asphyxia group, severe asphyxia group, compared the incidence and severity of MODS in both groups. Results The incidence of MODS in preterm asphyxia group was higher than that in term infantile asphyxia group (χ ~ 2 = 5.37, P <0.05). The severity of MODS after asphyxia: There was a significant difference in asphyxia group, advanced preterm asphyxia group and full-term asphyxia group (χ ~ 2 = 6.11, P <0.05), and gestational age was positively correlated with the incidence of M ODS r = 0.29). There was a positive correlation between gestational age and MODS after asphyxia (r = 0.35). The incidence of MODS in mild asphyxia group and severe asphyxia group was significantly different (χ ~ 2 = 9.30, P <0.05) There were significant differences in the severity of MODS between degrees of asphyxia group and severe asphyxia group (χ ~ 2 = 6.80, P <0.05). Conclusion The incidence of MODS after perinatal asphyxia in premature infants is higher than that in term infants. The smaller the gestational age, the higher the incidence of MODS after asphyxia, the heavier the degree is. The heavier the perinatal asphyxia is, the higher the incidence of MODS is. The more serious the degree.