A Clinical Study On Multi-organ Impairment In Neonatal Asphyxia

Objective The purpose of this thesis is to provide basis for prevention andtreatment to multi-organ impairment in neonatal asphyxia by evaluating the incidencerate and clinical features of multi-organ impairment and analyzing the relation betweenperinatal factors and multi-organ impairment and lower the morality of asphyxia.Method By collecting neonatal asphyxia clinical data from the first affiliatedhospital of Henan university of science and technology from January2007to January2010, this thesis reviews128infants with choking case, according to the clinicalmanifestations after admission and auxiliary examination results, divides into groupsbased on the damaged parts of organ function and the asphyxia, and lists tables tocompare them. Firstly, this thesis analyzes the investigation results by the use ofSPSS17.0; Secondly, it inspects the data by Chi-square test; then it respectivelyregards the perinatal factors of neonatal asphyxia as the dependent variable and thetested meaningful clinical factors as the independent variable to make multi-factorLogistic regression analysis; lastly, this thesis concludes the risk factors of theinfluenced neonatal asphyxia.Results The results showed that (1) the incidence of organ impairment afterasphyxia was77.3%including central nervous system impairment (69.5%),cardiacimpairment(46.3%),pulmonary impairment(42.6%),renal impairment (34.8%), hepaticimpairment (31.3%),gastrointestinal impairment (5.4%)and multi-organ (53.9%);(2)The incidence rate of multi—organ damage and morality were related to severityof asphyxia and there is an obvious difference between them(P<O．001)；(3)Thesingle factor Chi-square test results show that the covariant including the gestationalage (P=0.003， OR=4.135),the birth weight(P=0.004， OR=4.408),the degree ofasphyxia(P=0.000，OR=0.21),5minApgar mark(P=0.000，OR=5.000), and the newresuscitation technique(P=0.000，OR=4.801), are related to the damaged parts of neonatal asphyxia organ function based on the statistic result（P＜0.01）, instead ofmeconium-stained amniotic fluid, umbilical cord factor and fetal distress because of（P＞0.05）.(4) The results of Multi-factor Logistic regression analysis show thatonly one covariant that is degree of asphyxia get into model, which is meaningful（P=0.024,OR=3.774,95%CI=1.187-11.994) and related to the damaged parts of organfunction. The degree of asphyxia is the independent risk factor of the damaged parts ofneonatal asphyxia organ function instead of the gestational age, the birth weight, thedegree of asphyxia,5minApgar mark, and the new resuscitation technique.Conclusion Firstly, the brain damage happens more frequently than others toamong the damaged parts of neonatal asphyxia organ function. Secondly, thegestational age, the birth weight, the degree of asphyxia,5minApgar mark, and thenew resuscitation technique are closely related to the neonatal asphyxia organ functionimpairment. Thirdly, the degree of asphyxia is an independent risk factor. Lastly,measures should be taken to strengthen perinatal health care, spread the use of newresuscitation technique and supervision after resuscitation and protect multi-organfunction. It also should prevent every organ timely and deal with various kinds ofcomplications to improve the treatment to neonatal asphyxia.