南非新生儿轻度和中度缺氧缺血性脑病

R. Malan, J. van der Linde, A. Kritzinger, M. Coetzee, M. Graham, E. Krüger
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引用次数: 0

摘要

背景。目前尚缺乏明确的新生儿轻度和中度缺氧缺血性脑病(HIE)的风险概况。描述和比较南非新生儿轻度和中度HIE的相关因素。一项前瞻性的比较设计用于描述南非城市三级学术医院轻度(n=13)和中度(n=33) HIE新生儿的因素。采用改良的Sarnat分期进行HIE诊断和脑病分级。记录汤普森分数。回顾参与者的临床记录以确定因素。获得描述性数据。卡方检验和Fisher精确检验用于比较分类数据,Mann-Whitney检验用于比较组间连续数据。两组入院人数(p<0.001)和最高汤普森评分(p<0.001)之间存在显著差异。轻度组APGAR评分在5分钟(p=0.012)和10分钟(p=0.022)显著高于中度组。复苏时间(p=0.011)和自主呼吸时间(p=0.012)在两组间也有显著差异。接受治疗性低温治疗(TH)的中度受试者明显多于轻度受试者(p<0.001)。两组间临床试验及管理因素差异显著。这些发现为多学科团队提供了对异质性HIE人群的更多了解,并为在资源有限的情况下确定符合条件的新生儿提供了新的证据。
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South African neonates with mild and moderate hypoxic-ischaemic encephalopathy
Background. Clear risk profiles of neonates with mild and moderate hypoxic-ischaemic encephalopathy (HIE) are lacking.Objective. To describe and compare factors associated with mild and moderate HIE in South African neonates.Methods. A prospective, comparative design was used to describe factors among South African neonates with mild (n=13) and moderate (n=33) HIE in an urban tertiary academic hospital. HIE diagnosis and encephalopathy grading were conducted using the modified Sarnat stages. Thompson scores were recorded. Participants’ clinical records were reviewed to identify factors. Descriptive data were obtained. Chi-square and Fisher’s exact tests were used to compare categorical data, and Mann-Whitney tests were used to compare continuous data between groups.Results. Significant differences were found between groups’ admission (p<0.001) and highest Thompson scores (p<0.001). The mild group’s APGAR scores were significantly higher than those of the moderate group at five (p=0.012) and ten minutes (p=0.022). Duration of resuscitation (p=0.011) and time to spontaneous respiration (p=0.012) also differed significantly between groups. Significantly more moderate than mild participants received therapeutic hypothermia (TH) (p<0.001).Conclusion. Clinical tests and management factors differed significantly between groups. The findings provided the multidisciplinary team with an increased understanding of the heterogeneous HIE population and add to existing evidence for identifying neonates eligible for TH in resource-limited settings.
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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
21
审稿时长
12 weeks
期刊最新文献
Low birthweight and maternal smoking as predictors of infant lung function from a South African birth cohort within low socioeconomic communities An audit of electronic discharge summaries of neonates admitted with hypoxic ischaemic encephalopathy to tertiary hospitals in [City], 2018–2019. Borderline hypernatraemia and mortality rates in South African infants: A single-centre observational study The cost-effectiveness and value of C-reactive protein in the diagnosis and management of neonatal late-onset sepsis in resource-limited settings Issue 4
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