Dindić Jasmina, Obradović Slobodan
Razvojno savetovaliste, Decji dispanzer, Dom zdravlja "Dr M. IIiVć", Kragujevac.
Med Pregl. 2006 Nov-Dec;59(11-12):531-8. doi: 10.2298/mpns0612531d.
Asphyxia i a condition caused by lack of oxygen in tissues and organs. The basic pathogenic mechanisms of asphyxia are: 1)hypoxemia, 2) ischemia. The effects of perinatal asphyxia on the brain of a neonatal baby are critical in development of hypoxic-ischemic encephalopathy. The diagnosis of hypoxic-ischemic encephalopathy is based on clinical data including course of pregnancy and delivery (Apgar score) and especially on the neurological status of the newborn (consciousness, tonus, convulsions, reflexes, vegetative functions, etc.) and it can be confirmed by biochemical analysis and neurological examinations. The aim of this paper is to determine the importance of prenatal and perinatal risk factors for hypoxic-ischemic encephalopathy, as well as their effects on the development of neurological complications and further neurological problems. The research included 148 newborn infants born in the period from January 1, 1996 to January 1, 1999, with gestational age of 27 to 42 weeks, with hypoxic ischemic lesions of the central nervosus system. The control group included 58 children of the same age and the same gestation, with generalized hypotonia ("floppy infant") but without any signs of hypoxic ischemic lesions of the central nervous system. In the group of examined newborn infants with hypoxic ischemic lesions, from 149 children 1 (0.67%) died, 87 (53.89%) had normal findings, whereas the handicap was established in 61 (40.94%). Perinatal asphyxia affects the fetus and newborn infants not by individual factors, but with at least three or four associated factors. The disorders caused by asphyxia are in inverse proportion to the duration and intensity of hypoxic insults and the gestational age of the newborn.
窒息是一种由组织和器官缺氧引起的病症。窒息的基本致病机制为：1）低氧血症，2）局部缺血。围产期窒息对新生儿大脑的影响在缺氧缺血性脑病的发展过程中至关重要。缺氧缺血性脑病的诊断基于临床数据，包括妊娠和分娩过程（阿氏评分），尤其基于新生儿的神经学状况（意识、肌张力、惊厥、反射、自主功能等），并且可以通过生化分析和神经学检查来确诊。本文的目的是确定产前和围产期危险因素对缺氧缺血性脑病的重要性，以及它们对神经并发症发展和进一步神经问题的影响。该研究纳入了1996年1月1日至1999年1月1日期间出生的148例新生儿，其孕周为27至42周，患有中枢神经系统缺氧缺血性损伤。对照组包括58例年龄和孕周相同的儿童，他们患有全身性肌张力减退（“松软婴儿”），但无中枢神经系统缺氧缺血性损伤的任何迹象。在患有缺氧缺血性损伤的被检查新生儿组中，149名儿童中有1名（0.67%）死亡，87名（53.89%）检查结果正常，而61名（40.94%）被确定为残疾。围产期窒息对胎儿和新生儿的影响并非由个别因素导致，而是至少由三或四个相关因素共同作用。窒息所引发的病症与缺氧损伤的持续时间和强度以及新生儿的孕周成反比。
