摘要
目的探讨低体重早产儿颅脑病变的影响因素。方法选取衢州市人民医院出生的低体重早产儿262例,依据MRI检查结果将入组早产儿分为病变组和无病变组,并对两组早产儿的临床资料进行单因素和多因素Logistic回归分析。结果247例低体重早产儿中,发生颅脑病变的有89例,占总体的36.03%,其中出血性颅脑病变61例,占低体重早产儿的24.69%(脑室出血50例,脑实质出血5例,小脑出血4例,蛛网膜下腔出血2例),非出血性颅脑病变28例,占总体的11.34%(脑室周围白质软化24例,基底节软化2例,额叶软化2例)。两组低体重早产儿的胎龄、新生儿体重、新生儿Apgar评分、住院时间及宫内发育迟缓、低氧血症、窒息、动脉导管未闭、机械通气、妊娠期高血压、产前未使用激素比例存在显著差异(均P<0.05)。胎龄≤32周(OR:1.793,95%CI:1.193~2.695)、新生儿体重2 000g(OR:1.937,95%CI:1.035~3.625)、动脉导管未闭(OR:2.849,95%CI:1.153~7.040)、新生儿Apgar评分低(OR:2.184,95%CI:1.164~4.098)、产前未使用激素(OR:2.964,95%CI:1.073~8.186)是影响低体重早产儿颅脑病变的高危因素(均P<0.05)。结论低体重早产儿颅脑病变的发生与胎龄、出生体重、动脉导管未闭和新生儿Apgar评分密切相关,而产前使用激素能够预防颅脑病变的发生。临床上应重视高危患儿,并给予及时有效的干预和治疗。
Objective To investigate the influencing factors of craniocerebral lesions in premature infants with low birth weight.Methods 262 cases of premature infants with low birth weight born in our hospital from July 2015 and May 2019 were enrolled and divided into the lesion group and no lesion group according to the results of MRI examination.And univariate and multivariate logistic regression analysis were performed on the clinical data of two groups.Results Among the 247 premature infants with low birth weight,89(36.03%) cases of craniocerebral lesions have occurred.Among them,61(24.69%) cases of hemorrhagic craniocerebral lesions(including 50 cases of intraventricular hemorrhage,5 cases of cerebral parenchymal hemorrhage,4 cases of cerebellar hemorrhage,2 cases of subarachnoid hemorrhage).And 28(11.34%) cases have occurred non-hemorrhagic craniocerebral lesions(including 24 cases of periventricular leukomalacia,2 cases of softening of the basal ganglia,2 cases of frontal softening).Significant differences were found in gestational age,neonatal weight,neonatal Apgar score,length of hospital stay,intrauterine growth retardation,hypoxemia,asphyxia,patent ductus arteriosus,mechanical ventilation,gestational hypertension and the proportion of no treatment of antenatal corticosteroids between the two groups(all P<0.05).Gestational age≤32 weeks(OR=1.793,95%CI:1.193-2.695),neonatal birth weight≤2 000 g(OR=1.937,95%CI:1.035-3.625),patent ductus arteriosus(OR=2.849,95%CI:1.153-7.040),low Apgar score(OR=2.184,95%CI:1.164-4.098) and no treatment of antenatal corticosteroids(OR=2.964,95%CI:1.073-8.186) were independent risk factors craniocerebral lesions in premature infants with low birth weight(all P<0.05).Conclusion The risk of craniocerebral lesions in premature infants with low birth weight is closely related to gestational age,birth weight,patent ductus arteriosus and Apgar score,while treatment of antenatal corticosteroids can prevent the occurrence of craniocerebral lesions.So we should pay more attention to high-ri
作者
龚敏
徐潇
郑雪辉
钱颖
GONG Min;XU Xiao;ZHENG Xuehui;QIAN Ying(Peoples Hospital of Quzhou,Zhejiang Quzhou 324000,China;Jinhua Peoples Hospital,Zhejiang Jinhua 321000,China)
出处
《中国妇幼健康研究》
2020年第4期418-422,共5页
Chinese Journal of Woman and Child Health Research
关键词
低体重早产儿
颅脑病变
动脉导管未闭
产前使用激素
premature infants with low birth weight
craniocerebral lesions
patent ductus arteriosus
treatment of antenatal corticosteroids
