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目的探讨发生围产期窒息的新生儿复苏后哪些临床表现是新生儿颅脑损伤的早期诊断依据,何时可确立新生儿颅脑损伤的诊断。方法通过对新生儿出生后30 min、3 h6、h1、2 h、24 h、72 h的动态观察并进行统计学处理。结果 30 min内窒息新生儿兴奋激惹发生率10%,12 h消失。肢体肌张力异常(肌张力减低或增高)12 h接近消失。而新生儿颅脑损伤患儿兴奋发生率高达60%,上、下肢肌张力异常和原始反射减弱60%,并持续至72 h以后。结论窒息儿生后出现兴奋激患3~6 h加重或转为抑制,并伴有肢体肌张力的异常或拥抱、握持反射减弱,便可早期诊断新生儿颅脑损伤。
Objective To investigate the clinical manifestations of neonates with perinatal asphyxia after resuscitation is the basis of early diagnosis of neonatal brain injury, when the diagnosis of neonatal brain injury can be established. Methods The dynamic observation of newborns at 30 min, 3 h6, h1, 2 h, 24 h, 72 h after birth was performed and statistically analyzed. Results The incidence of excitement and irritability in asphyxiated newborns within 10 minutes was 10% and disappeared after 12 hours. Abnormal muscle tone (reduced or increased muscle tension) 12 h nearly disappeared. The neonatal brain injury in children with excitability rate as high as 60%, upper and lower limb muscle tone abnormalities and the original reflex decreased 60%, and lasted 72 h later. Conclusion Asphyxial children with excitement after 3 ~ 6 h agitation exacerbated or converted to inhibition, accompanied by limb muscle abnormalities or hugs, hold the reflex, we can early diagnosis of neonatal brain injury.