{"id":97304,"date":"2018-03-11T10:17:50","date_gmt":"2018-03-11T10:17:50","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/analisis-pronostico-de-la-hipoxia-isquemia-perinatal\/"},"modified":"2018-03-11T10:17:50","modified_gmt":"2018-03-11T10:17:50","slug":"analisis-pronostico-de-la-hipoxia-isquemia-perinatal","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/pediatria\/analisis-pronostico-de-la-hipoxia-isquemia-perinatal\/","title":{"rendered":"Analisis pron\u00f3stico de la hipoxia-isquemia perinatal."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Rosa Patricia Arias Llorente <\/strong><\/h2>\n<p>Introducci\u00f3n: la hipoxia-isquemia perinatal (hp) contin\u00faa siendo en la actualidad una importante causa de morbi-mortalidad perinatal y d\u00e9ficits neurol\u00f3gicos a largo plazo, tanto f\u00edsicos como intelectuales.  objetivos: conocer la incidencia de asfixia perinatal, encefalopat\u00eda hip\u00f3xico-isqu\u00e9mica (ehi), y secuelas neurol\u00f3gicas, descripci\u00f3n de estas con especial atenci\u00f3n a los trastornos menores. Analizar la utilidad como marcadores pron\u00f3sticos de secuelas neurol\u00f3gicas  de determinadas  variables perinatales,  pruebas de imagen, eeg,  presencia y gravedad de ehi.  pacientes y m\u00e9todos: se seleccionan pacientes con antecedentes de hp, seg\u00fan criterios de inclusi\u00f3n, de los que se recogen datos prenatales, perinatales y de evoluci\u00f3n en consultas externas, realiz\u00e1ndose posteriomente una reevaluaci\u00f3n cl\u00ednica de secuelas neurol\u00f3gicas, test de memoria, aprendizaje y ci. resultados: estudio prospectivo de 67 pacientes con antecedentes de hp cuya incidencia fue de 3-6,5\/1000 rn vivos, la de ehi 4,2 % y secuelas en 28,3%,siendo las m\u00e1s frecuentes las motoras. Pci 5,9%, mortalidad 4,5%.La combinaci\u00f3n entre apgar <3 a  los 5 y ph umbilical < 7,1 fue una buena predictora de mortalidad neonatal. Aumentaron estad\u00edsticamente el riesgo de secuelas en an\u00e1lisis multivariante: persistencia del eeg alterado (p=0,001 con un rr=46,3, ic 95%=4,3-489) y el desarrollar cl\u00ednica de ehi (p=0,012 con un rr=8,5, ic 95%=1,6-45,8). Cociente intelectual (ci) medio de la muestra el 92,9 (ds de +-19,4). Puntuaci\u00f3n media del grupo en memoria verbal deficiente, resto subtest memoria nivel medio. Ci de aquellos pacientes que continuaron con el eeg alterado en su evoluci\u00f3n \/ eeg normal (64,3 +- 32,7 \/97,4 +-11,6; con p=0,037). Se hallaron diferencias en el ci dependiendo del tipo de trazado mantenido en el eeg (p=0,02). La variable diagn\u00f3stica que mayor sensibilidad (90%), especificidad (96,5%), vpp (81,8%) y vpn (98,2%) demostr\u00f3 para predecir d\u00e9ficit moderados o graves fue la evoluci\u00f3n del eeg. conclusiones: las variables perinatales no son buenos marcadores pron\u00f3sticos de secuelas. La alteraci\u00f3n y el tipo de trazado de los eeg neonatales seriados han demostrado el mejor valor pron\u00f3stico tanto para secuelas f\u00edsicas como intelectuales. Nuestros pacientes presentan una deficitaria memoria verbal. Hay secuelas menores aisladas que condicionan la vida diaria y el rendimiento escolar.\n\n\n\n&nbsp;\n\n\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Analisis pron\u00f3stico de la hipoxia-isquemia perinatal.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Analisis pron\u00f3stico de la hipoxia-isquemia perinatal. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Rosa Patricia Arias Llorente <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Oviedo<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 20\/11\/2009<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Jose Lopez Sastre<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Jos\u00e9 Mar\u00eda Fraga berm\u00fadez <\/li>\n<li>Manuel Moro serrano (vocal)<\/li>\n<li>corsino Rey gal\u00e1n (vocal)<\/li>\n<li>Jos\u00e9 Quero jim\u00e9nez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Rosa Patricia Arias Llorente Introducci\u00f3n: la hipoxia-isquemia perinatal (hp) contin\u00faa siendo en la actualidad una importante causa [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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