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新生儿窒息对新生儿臂丛损伤发生影响的初步研究

ISSN号：1673-9086
期刊名称：《传承》
时间：0
分类：R722.144[医药卫生—儿科;医药卫生—临床医学]
作者机构：[1]东南大学附属第二医院骨科,南京210003, [2]苏州大学医学部博习临床解剖学研究所, [3]吉林省人民医院
相关基金：中国博士后基金资助项目（20090460023）; 江苏省卫生厅重大科研项目（H200515）; 汉德公司卫生科研资助项目（T2009001）; 东南大学附属第二医院人才引进资助项目（2010001）

关键词：新生儿臂丛损伤, 危险因素, 新生儿窒息, 发生机制, neonatal brachial plexus palsy, risky factor, neonatal asphyxia, pathogenesis

中文摘要：

目的：探讨新生儿窒息对新生儿臂丛神经损伤（NBPP）发生的影响程度。方法：采集102例NBPP病例资料和2 937例正常新生儿资料,对2组资料中难产、手术助产、出生体重≥4 000 g及新生儿窒息等因素采用完全随机设计的χ2检验,并进一步用单因素和多因素logistic模型分析。结果：难产、手术助产、新生儿出生体重≥4 000 g和新生儿窒息史,NBPP病例组与对照组之间的差异均有统计学意义（P〈0.001）;遭遇难产、手术助产（胎吸、产钳、2种以上方式）、出生体重≥4 000 g和有窒息史的新生儿患NBPP的风险分别增加约28倍（OR=29.0,95%CI=13.1~64.5）,17~150倍（OR=18.6,95%CI=7.4~46.9;OR=16.9,95%CI=4.9~58.9;OR=151.7,95%CI=73.2~207.2）,41倍（OR=42.4,95%CI=19.7~91.3）和130倍（OR=131.8,95%CI=52.8~328.9）。结论：新生儿窒息与难产、手术助产（胎吸、产钳）和新生儿出生体重≥4 000 g一样,是NBPP发生的高危因素。

英文摘要：

Objective： To investigate the effects of neonatal asphyxia on the incidence of neonatal brachial plexus palsy（NBPP）.Methods： Data of 102 patients with NBPP and of 2 937 healthy neonates were collected.Factors including dystocia,surgery-assisted delivery,birth weight ≥ 4 000 g,and neonatal asphyxia in these 2 groups were analyzed by a completely randomly designed χ2 test.The data were further analyzed with univariate and multivariate logistic models.Results： Between the NBPP and control groups,significant differences were observed for dystocia,surgery-assisted delivery,birth weight ≥ 4 000 g,and neonatal asphyxia history（P0.001）.The risks of NBPP increased by 28.0 times（odds ratio =29.0,95% confidence interval =13.1~64.5） among neonates who had dystocia,by 15.9,17.6 and 150.7 times respectively in those born by means of surgery-assisted delivery（with the help of obstetric forceps,OR=16.9,95% CI=4.9~58.9;with vacuum assistance,OR=18.6,95% CI=7.4~46.9;and with 2 or more methods,OR=151.7,95% CI=73.2~207.2）,by 41.4 times in those with birth weight ≥ 4 000 g（OR=42.4,95% CI=19.7~91.3）,and by 130.8 times in those with neonatal asphyxia history（OR=131.8,95% CI=52.8~328.9）.Conclusion： Neonatal asphyxia,dystocia,vacuum-assisted or forceps delivery,and neonatal birth weight ≥ 4 000 g are risky factors for NBPP.

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