摘要
目的 探讨早产儿脑室周围-脑室内出血（PVH-IVH）凝血功能的变化、影响因素及评估预后.方法 选择81例PVH-IVH早产儿为观察组,无PVH-IVH 81例早产儿为对照组,采用酶联免疫法检测凝血酶原时间（PT）、部分凝血酶原时间（APTT）、纤维蛋白原（FiB）、D-D聚体,对可能引起早产儿PVH-IVH的临床因素进行统计学分析,并通过行为神经评分（NBNA）测定初步评估预后.结果 观察组早产儿胎龄（30.9±1.79）周,对照组胎龄（31.36±1.39）周,2组比较差异有统计学意义（F=6.52,P=0.012）;观察组APPT、D-D聚体水平与对照组比较差异均有统计学意义（P均＜0.05）;通过Logistic分析显示,胎龄、新生儿呼吸窘迫综合征、高体积分数氧、机械通气为高危因素（OR =3.98、1.72、2.99、5.65,P均＜0.05）.NBNA测定：对照组NBNA总分为（36.51±2.32）分,观察组为（34.28-±3.12）分,2组比较差异有统计学意义（t=9.16,P＜0.05）.结论 PVH-IVH的发生是胎龄、新生儿呼吸窘迫综合征、高体积分数氧、机械通气等多种因素相互作用的复杂结果.尽量预防早产,积极治疗凝血功能异常的早产儿,避免NRDS发生和缩短机械通气的时间,可避免PVH-IVH发生.
Objective To investigate the coagulation function,the related factors and prognosis of preterm infants with periventricular hemorrhage-intraventricular hemorrhage （PVH-IVH）.Methods Eighty-one preterm infants with PVH-IVH and 81 infants with non-PVH-IVH as a control were enrolled in the study.The changes in activated thromboplastin time（PT）,activated partial thromboplastin time （APTT）,Fibrinogen and D-dimer were determined by enzyme-linked immunosorbent assay.Clinical factors which were related to PVH-IVH in infants were analyzed with statistical analysis and prognosis was assessed with neonatal behavioral neurological assessment （NBNA）.Results The average of gestational age in PVH-IVH group was（30.9 ± 1.79）weeks,in control group were （31.36 ± 1.39）weeks,and there was significant difference between the 2 groups （F =6.52,P =0.012）.There were significant differences in APTI,and D-dimer between PVH-IVH and non-PVH-IVH infants（all P 〈 0.05）.Multivariate Logistic regression analysis showed that the related factors included gestational age,neonatal respiratory distress syndrome（NRDS）,hyperoxia,and mechanical ventilation（OR =3.98,1.72,2.99,5.65,all P 〈 0.05）.The NBNA scores of the 2 groups were also significantly different（t =9.16,P 〈 0.05）.Conclusions The occurrence of PVH-IVH is very complex resulted from gestational age,NRDS,hyperoxia,mechanical ventilation and other factors.In order to avoid the occurrence of intracranial hemorrhage and improve the life quality of preterm infants,the NRDS was prevented as far as possible,coagulation abnormalities were managed positively and the mechanical ventilation was shortened.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2014年第18期1397-1399,共3页
Chinese Journal of Applied Clinical Pediatrics
基金
济南市卫生局科技计划项目（2010-27）
关键词
脑室周围-脑室内出血
凝血功能
相关因素
新生儿行为神经评分
Periventricular hemorrhage-intraventricular hemorrhage
Coagulation function
Related factors
Neonatal behavioral neurological assessment scores
