Turgut AĞZIKURU, Ayça VİTRİNEL, Serdar CÖMERT, Gülay Çiler ERDAĞ, Feza AKSOY, YASEMİN AKIN

Hipoksik iskemik ensefalopatide izlem

Amaç: HIE nedeniyle yenidoğan ünitesinde yatan hastalarımızın morbidite, mortalite oranlarını belirlemek, Apgar skorunun, konvülziyonıın ve Sarnat&Sarnat HIE evrelemesinin nörolojik defisitin erken tahmini açısından uygunluğunu de ğ e de n dirm e yi am a ç la dik. Materyal ve Metod : Ocak 2000 ile Haziran 2001 tarihleri arasında 18 ay süre içerisinde yenidoğan ünitesinde yatan 679 hastadan asfiksisonrası HIE tanısı konulan 51 term yenidoğan bebek alınmıştır. Bulgular: Tüm hastalar SarnatfrSamat HIE evrelemeşine göre evrelendirildi. 8 (%15.68) olgu Evre I, 28 (%54.90) olgu Evre live 15 (%29.42) olgu Evre III olarak değerlendirildi. HIE olguların 10'u (%19.60) yenidoğan döneminde eksitus oldu. 17 (%33.34) olgu kontrole gelmezken 24 (%47.06) olgu kontrole geldi. Kontrole gelen hastalar 3,6,9 ve 12. aylarda fizik ve nörolojik muayeneleri yapıldı. Evre I, II, ve IIIiçin morbidite oranlan sırasıyla %0, %14.28, ve %6.66 ve mortalite oranları ise yine sırasıyla %0, %3.57, ve %60 olarak tespit edildi. Evrelerin artması ile nörolojik def is it ve mortalite arasında ileri derecede ilişki saptandı (p

Anahtar Kelimeler:

Hipoksi-iskemi, beyin, Süt çocuğu, yenidoğan, Apgar skoru, Ölüm oranı, Hastalık oranı

The neurological outcome of hypoxic ischemic encephalopathy

Objective: The purpose of this study was to determine the morbidity and mortality rates of HIE patients in our neonatal unit and to evaluate the prognostic values of Apgar scores, convulsions and Sarnat Sarnat staging. Mateikd and Methods: Of the 679 neonates followed in our unit between )anuary 2000 and June 2001, 51 (7.51 %) fuUterm infants with HIE were included in our study. Results: AU of them were classifed according to Samat Samat staging system as mHd (stage I, 8 cases 15.68%), moderate (stage II, 28 cases 54.90%) and severe (stage III, 15 cases 29.42 %) 10 of the patients (19.60%) died in the neonatal period. 24 patients {47.06 %lwere foHowed up for a year at 3™, 6™ , 9™" and 12th months withphysical and neurological examinations. The morbidity rates for 3 stages were 0%, 3.57% and 60% respectively. There was a significant relation between the neurological findings and higher Sarnat Sarnat HIE grades (p 0.01). Conclusion: In our patients we found significant relation between the increased SarnatEfSarnat HIE grade and mortality and morbidity; but no signicat relation between the Apgar score and norologic outcome and mortality.

Keywords:

Hypoxia-Ischemia, Brain, Infant, Newborn, Apgar Score, Mortality, Morbidity,

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