ACUTE NEONATAL MORBIDITY AND LONG-TERM CENTRAL-NERVOUS-SYSTEM SEQUELAE OF PERINATAL ASPHYXIA IN TERM INFANTS
ACUTE NEONATAL MORBIDITY AND LONG-TERM CENTRAL-NERVOUS-SYSTEM SEQUELAE OF PERINATAL ASPHYXIA IN TERM INFANTS
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DOI：
10.1016/0378-3782(91)90191-5
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发表时间：
1991-05-01
影响因子：
2.5
通讯作者：
NANDYAL, R
中科院分区：
文献类型：
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作者：
SHANKARAN, S;WOLDT, E;NANDYAL, R
28例重度围产期窒息的足月新生儿被转介到三级新生儿重症监护室（NICU）。 窒息的发生率包括肺（n = 24）、中枢神经系统（n = 22）、肾（n = 15）、心（n = 14）、代谢（n = 13）和血液系统（n = 10）。 大多数新生儿累及三个以上器官系统。 24名新生儿存活了新生儿病程，在NICU出院时，除中枢神经系统外的所有系统影响均已消退。 5岁（60个月）时，14名儿童的神经系统检查正常，9名痉挛性四肢瘫痪，1名偏瘫。 9名儿童的麦卡锡一般认知指数（GCI）大于或等于84，3名儿童的GCI在68至83之间，12名儿童的GCI得分< 67。 新生儿癫痫发作、肾脏问题、3个月时的小头畸形和新生儿后期癫痫发作与神经功能异常或GCI < 67相关。 出生后第一年的神经系统检查可以揭示出生窒息的儿童在5岁时是否相对正常，或者他们是否会表现出相当大的延迟。
Twenty-eight term neonates with severe perinatal asphyxia were referred to a tertiary neonatal intensive care unit (NICU). The morbidity of asphyxia included involvement of the pulmonary (n = 24 infants), central nervous system (n = 22), renal (n = 15), cardiac (n = 14), metabolic (n = 13) and hematologic (n = 10) systems. The majority of neonates had more than three organ systems involved. Twenty-four neonates survived the neonatal course and at NICU discharge all system effects other than the central nervous system had resolved. At 5 years (60 months), 14 children had a normal neurologic examination, 9 had spastic quadriplegia and one had hemiplegia. Nine children had a McCarthy General Cognitive Index (GCI) greater-than-or-equal-to 84, 3 had a GCI between 68 and 83 and 12 scored < 67. Neonatal seizures, renal problems, microcephaly at 3 months, and post-neonatal seizures were associated with an abnormal neurologic outcome or a GCI < 67. A neurologic examination during the first year of life may reveal whether children with birth asphyxia will be relatively normal at age 5 years or whether they will show considerable delay.