The Clinical Research Of Neonatal Asphyxia-related Organ Damages,Risk Factors And Recovery

Objective(1)To study the relationship between neonatal asphyxia and organ damages,electrolyte disturbances and pathoglycemia.(2)To analyze the risk factors of neonatal asphyxia-related multi-organ damages.(3)To make a systematic evalution damages of asphyxial neonates’ viscera is to investigate prophylactico-therapeutic measures(Study viscera function impairment of outcome after neonatal asphyxia and the prevention and control measures).Methods Evaluate the functions of neonates’ different viscera through cheeking of occurent clinic symptoms,body characteristics,and laboratory and imges indications in 153 cases with asphyxial after their birth.Univariate analysis and logistic regression analysis were used to the neonatal asphyxia-related multi-organ damages.Results The results showed that(1)The incidence of multi-organs damages involvement after asphyxia was 60.1% including pulmonary damage(54.2%),cardiac damage(53.6%)、gastrointestinal damage(53.6%),central nervous system damage(40.5%),renal damage(36.9%)and liver damage(11.1%).The frequency of multi-organ damages involvement in mild asphyxia group(52.5%)was obviously lower than that in severe asphyxia group(90.3%)(χ2=11.69,P<0.005).The frequency of hyponatremia,hypocalcemia and hyperglycemia in severe asphyxia group was obviously higher than that in mild asphyxia group(P<0.005).(2)premature,intrauterine asphyxia,severe asphyxia,meconium-stained amniotic fluid and Apgar score(≤5 at 5minutes)are able to increase the risk for multiple organ damage after neonatal asphyxia..Moreover,premature,intrauterine asphyxia and the severe asphyxia are independent risk factors for neonatal asphyxia multiple organ damage.(3)Each organ damages mainly occurred within 24 hours after the neonatal asphyxia,but there are differences between the multi-organ damage occured time and recovery.(4)Cardiac damage:The serum levels of CK-MB within 24 hours,24 hours to 3 days and 3 days to 7 days which in severe asphyxia group were significantly higher than those in mild asphyxia group(P<0.01).They all peaked within 24 hours after birth,then began to decrease from the third day,the serum of CK-MB levels of mild asphyxia reduced to normal on the seventh day.The level of severe asphyxia decreased obviously at the seventh day but was still maintain higher level.Cerebral damage: There was significant difference of serum NSE level between mild asphyxia and severe Asphyxia group(P<0.01).The levels of severe asphyxia group which in each time point were significantly higher than those in mild asphyxia group(P<0.01).Pulmonary damage: The serum levels of Pa O2 in severe asphyxia group were significantly lower than those in mild asphyxia group(P<0.01)no matter how long after birth.The serum level of Pa CO2 within 6 hours in severe asphyxia group were significantly higher than those in mild asphyxia(P<0.05).Kidney damage:The urine levels of α1-MG,Alb and β2-MG in severe asphyxia group were significantly lower than those in mild asphyxia group on seventh day(P<0.05).In severe asphyxia group,the urine levels of α1MG,Alb and β2-MG On the third day and seventh days were significantly higher than those in mild asphyxia group(P<0.05).Liver damage:The serum levels of ALT within 3 days after birth,and 3 days to 7 days which in severe asphyxia group were significantly higher than those in mild asphyxia group(P<0.05),then began to decrease from the third day.Conclusions The neonatal asphyxia often accompany with organ damage,pay attention to perinatal health care、extend the new neonatal asphyxia recovery technology and took the recovery reasonably after promptly monitions,reduce the multi-organ damage after the newborn suffocates,enhanced the life quality for the newborn.