新生儿缺氧缺血性脑病诊断标准中存在的问题

Suggestions on diagnostic criteria of neonatal hypoxic2ischemic encephalopathy

摘要:

新生儿缺氧缺血性脑病(HIE) 是围生期窒息的严重并发症。国内HIE 的诊断标准和国外标准差 别很大,国内标准未将脐动脉血气和多脏器功能障碍(MOD) 指标纳入其中,容易误诊;国外标准较科学、全面,但过 于严格,可导致漏诊。目前,HIE 缺乏高度特异性和敏感性的诊断指标,诊断应结合病史、Apgar 评分、脐动脉血气、 MOD、头颅影像学及临床经过等多项指标对其进行综合评价。

Abstract:

Neonatal hypoxic2ischemic encephalopathy (HIE) is a severe complication of perinatal asphyxia. There are differences in the diagnostic criteria for HIE between China and overseas. The criteria of China do not include blood gas results of umbilical artery and incidence of multiple organs disorder (MOD) and can easily lead to misdiagnosis , while the oversea criteria are more scientific , perfect but over2strict which may result in missed diagnosis. At present , there are no highly specific and sensitive indexes for its diagnosis. So it is suggested that a diagnosis of HIE should be made according to history ,Apgar score , blood gas results , incidence of MOD ,brain images and clinic manifestations , etc.