Fernández-Carrocera L A, Flores-Tamez E, Salinas-Ramírez V, Bravo-Cabrera Z, Venta-Sobero J A, Udaeta-Mora E, Ugartechea J C, Lozano-González C H
Bol Med Hosp Infant Mex. 1989 Aug;46(8):554-8.
65 newborns with Apgar score less than 7 were studied. Initially 2 groups were formed. Group 1 with severe asphyxia Apgar 0-3 and group 2 with moderate asphyxia Apgar 4-7. Each group was divided according to Apgar score at 5 minutes; with good recuperation Apgar greater than or equal to 6 and bad recuperation Apgar less than 6. So four subgroups were formed. All patients were evaluated with Amiel Tison neurological examination at 12 months old. Of the 65 newborns, 52 (80%) had a normal neurologic examination, and only 12 (20%) were not normal. There were not significant statistic differences neither between the moderate and severely asphyxiated groups nor between the four subgroups at 5 minutes and their neurological examination. We conclude that the Apgar score at 5 minutes is not a good predictive of neurological sequelae, because there is a myriad of factors difficult to investigate in relation to the etiology of neurologic sequelae. We stress the importance of reviewing the original idea about the Apgar score as a useful method (instrument) to evaluate the hemodynamic and homeostatic conditions of the newborns.
对65例阿氏评分低于7分的新生儿进行了研究。最初分为2组。第1组为重度窒息,阿氏评分0 - 3分;第2组为中度窒息,阿氏评分4 - 7分。每组再根据5分钟时的阿氏评分进一步划分;恢复良好的阿氏评分大于或等于6分,恢复不良的阿氏评分小于6分。这样就形成了4个亚组。所有患儿在12个月大时均接受了阿米尔·蒂森神经学检查。65例新生儿中,52例(80%)神经学检查正常,只有12例(20%)不正常。中度和重度窒息组之间以及5分钟时的4个亚组与其神经学检查之间均无显著统计学差异。我们得出结论,5分钟时的阿氏评分并不是神经后遗症的良好预测指标,因为与神经后遗症病因相关的众多因素难以探究。我们强调重新审视将阿氏评分作为评估新生儿血流动力学和内环境稳定状况的有用方法(工具)这一原有观点的重要性。