摘要
目的探讨早产儿脑损伤(brain injury in premature infants,BIPI)临床特征及影响因素。方法选取2014年2月—2016年3月遂宁市中心医院收治的235例脑损伤早产儿作为研究对象,采用头颅核磁共振、B超进行脑损伤筛查,分析其脑损伤发病率与临床特征,并回顾性分析患者的临床资料,采用多因素Logistic回归分析早产儿脑损伤的影响因素,为临床上治疗早产儿脑损伤提供参考依据。结果胎龄<28周、28~34周、>34周的患儿进行脑室周围-脑室内出血(IVH)、脑室周围白质软化(PVL)发生率比较,差异均有统计学意义(P<0.05),说明早产儿胎龄越小,IVH、PVL的发生率越高。体质量<1.5 kg、1.5~2.0 kg、>2.0 kg进行IVH、PVL发生率比较差异有统计学意义(P<0.05),说明早产儿出生体质量越小,IVH、PVL的发生率越高。不同胎龄、出生体质量患儿PVL合并IVH的发生情况进行比较,差异无统计学意义(P>0.05)。早产儿脑损伤影响因素的单因素分析,结果显示,胎龄、出生体质量、分娩方式、围产期缺氧、感染、孕妇妊娠期并发症是影响早产儿出现脑损伤的影响因素。早产儿脑损伤影响因素多因素通过Logistic回归分析,结果显示,早产儿出现脑损伤的影响因素主要与胎龄、围产期缺氧有关。结论加强孕妇围产期身体的保健,预防早产,若出现早产现象,临床工作者应尽量延迟早产儿胎龄,避免胎儿出现围产期缺氧的现象,预防及积极治疗感染,这样才能更好地减少早产儿脑损伤的发生率。
Objective To investigate the clinical characteristics and influencing factors of brain injury in premature infants （BIPI）. Methods 235 cases of brain injury in premature infants admitted to our hospital between February 2014 and March 2016 were selected as subjects. Brain injury was screened by head magnetic resonance imaging （MRI） and B-mode ultrasonography. The clinical data of the patients was analyzed retrospectively. Multivariate Logistic regression was used to analyze the influencing factors of brain injury in preterm infants and provide reference for related treatment. Results The incidence of IVH and PVL in children of gestational age〈28 weeks, 28 to 34 weeks, and 〉34 weeks was significantly different （P〈0.05）, indicating that the smaller the gestational age of preterm children, the higher the incidence of IVH and PVL. Significant difference was detected in the incidence of IVH and PVL between infants of body weight〈1.5 kg, 1.5-2.0 kg and〉2.0 kg. The difference was statistically significant （P〈0.05）, indicating that the smaller the birth weight of premature children, the higher the incidence of IVH and PVL.The incidence of PVL and IVH in children with different gastational age and birth weight was not statistically significant（P〉0.05）. Univariate analysis of influencing factors of brain injury in premature infants showed that gestational age, birth weight, mode of delivery, perinatal hypoxia, infection and pregnancy complications were the influencing factors of brain injury in premature infants. Multivariate logistic regression analysis showed that the influencing factors of brain injury in premature infants were mainly related to gestational age and perinatal hypoxia. Conclusion Health care of pregnant women during the perinatal period should be improved to prevent premature delivery. If premature delivery occurs, clinicians should try to delay the gestational age of premature babies, prevent perinatal hypoxia in the fetus and infection, which can reduce the incidence of
作者
袁涛
李俊瑶
陈龙英
YUAN Tao LI Junyao CHEN Longying.(Department of Pediatrics, Suining Central Hospital, Suining Sichuan 629000, Chin)
出处
《空军医学杂志》
2017年第4期254-256,260,共4页
Medical Journal of Air Force
关键词
早产儿
脑损伤
临床特征
影响因素
premature infants
brain injury
clinical characteristics
influencing factors
