中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2009年
1期
5-11
,共7页
中华医学会儿科学分会新生儿学组%早产儿脑损伤研究多中心协作组
中華醫學會兒科學分會新生兒學組%早產兒腦損傷研究多中心協作組
중화의학회인과학분회신생인학조%조산인뇌손상연구다중심협작조
婴儿,早产%脑室%颅内出血%多中心研究%中国
嬰兒,早產%腦室%顱內齣血%多中心研究%中國
영인,조산%뇌실%로내출혈%다중심연구%중국
Infant%Premature%Cerebral ventricles%Intracranial Hemorrhages%Multicenter Studies%China
目的 中华医学会儿科学分会新生儿学组,组织14家三级甲等医院,进行了为期20个月的早产儿脑损伤多中心协作调查.报告其中9家提供完整资料的医院的早产儿脑室内出血(intraventricular hemorrhage,IVH)患病率的调查结果.方法 2005年1月至2006年8月,各参加单位对所有胎龄<37周的早产儿在生后3～7 d内常规进行初次床边头颅B超检查,以后每隔3～7 d复查1次,直至出院.脑室内出血的严重性采用Papile四级分级法.数据以x±s表爪,行X2检验.结果 9家医院出生或收住早产儿共3768例,其中发生IVH者352例,患病率为9.3%,重度患病率为2.1%(78/3768).分别为Ⅰ级IVH 23.3%(82/352),Ⅱ级IVH 54.5%(192/352),Ⅲ级IVH17.6%(62/352),Ⅳ级IVH 4.5%(16/352).早产儿IVH患病率(5.1%/14.1%)和重度IVH患病率(1.5%/2.7%)在4家妇婴医院均显著低于5家综合性或儿童专科医院(X2=89.045,P=0.000;X2=6.909,P=0.009).发生重度IVH的可能高危因素为胎膜早破、围产期室息、机械呼吸、双胎或多胎以及羊水污染等.结论本调查数据基本可以客观反映我国主要大城市早产儿IVH患病率的情况.由于我国60%以上的人口居住在农村,受农村医疗条件的限制,早产儿IVH患病率很有可能高于目前的调查结果,尚有待进一步组织包括乡村医院的多中心调查研究.
目的 中華醫學會兒科學分會新生兒學組,組織14傢三級甲等醫院,進行瞭為期20箇月的早產兒腦損傷多中心協作調查.報告其中9傢提供完整資料的醫院的早產兒腦室內齣血(intraventricular hemorrhage,IVH)患病率的調查結果.方法 2005年1月至2006年8月,各參加單位對所有胎齡<37週的早產兒在生後3～7 d內常規進行初次床邊頭顱B超檢查,以後每隔3～7 d複查1次,直至齣院.腦室內齣血的嚴重性採用Papile四級分級法.數據以x±s錶爪,行X2檢驗.結果 9傢醫院齣生或收住早產兒共3768例,其中髮生IVH者352例,患病率為9.3%,重度患病率為2.1%(78/3768).分彆為Ⅰ級IVH 23.3%(82/352),Ⅱ級IVH 54.5%(192/352),Ⅲ級IVH17.6%(62/352),Ⅳ級IVH 4.5%(16/352).早產兒IVH患病率(5.1%/14.1%)和重度IVH患病率(1.5%/2.7%)在4傢婦嬰醫院均顯著低于5傢綜閤性或兒童專科醫院(X2=89.045,P=0.000;X2=6.909,P=0.009).髮生重度IVH的可能高危因素為胎膜早破、圍產期室息、機械呼吸、雙胎或多胎以及羊水汙染等.結論本調查數據基本可以客觀反映我國主要大城市早產兒IVH患病率的情況.由于我國60%以上的人口居住在農村,受農村醫療條件的限製,早產兒IVH患病率很有可能高于目前的調查結果,尚有待進一步組織包括鄉村醫院的多中心調查研究.
목적 중화의학회인과학분회신생인학조,조직14가삼급갑등의원,진행료위기20개월적조산인뇌손상다중심협작조사.보고기중9가제공완정자료적의원적조산인뇌실내출혈(intraventricular hemorrhage,IVH)환병솔적조사결과.방법 2005년1월지2006년8월,각삼가단위대소유태령<37주적조산인재생후3～7 d내상규진행초차상변두로B초검사,이후매격3～7 d복사1차,직지출원.뇌실내출혈적엄중성채용Papile사급분급법.수거이x±s표조,행X2검험.결과 9가의원출생혹수주조산인공3768례,기중발생IVH자352례,환병솔위9.3%,중도환병솔위2.1%(78/3768).분별위Ⅰ급IVH 23.3%(82/352),Ⅱ급IVH 54.5%(192/352),Ⅲ급IVH17.6%(62/352),Ⅳ급IVH 4.5%(16/352).조산인IVH환병솔(5.1%/14.1%)화중도IVH환병솔(1.5%/2.7%)재4가부영의원균현저저우5가종합성혹인동전과의원(X2=89.045,P=0.000;X2=6.909,P=0.009).발생중도IVH적가능고위인소위태막조파、위산기실식、궤계호흡、쌍태혹다태이급양수오염등.결론본조사수거기본가이객관반영아국주요대성시조산인IVH환병솔적정황.유우아국60%이상적인구거주재농촌,수농촌의료조건적한제,조산인IVH환병솔흔유가능고우목전적조사결과,상유대진일보조직포괄향촌의원적다중심조사연구.
Objective Sponsored by the Subspeciahy Group of Neonatology of Pediatric Society, Chinese Medical Association, more than ten large hospitals joined the 20-month multicenter investigation for Brain Injuries in Premature Infants in China. This paper presents the results of the incidence of intraventricular hemorrhage (IVH) in premature infants in 9 hospitals of 7 big cities of China. All these hospitals were Third Class and Grade A hospitals. Methods All premature infants with a gestational age less than 37 weeks in the 9 hospitals were subjected to routine cranial ultrasound examination within 3～7 days after birth, and then the examination was repeated every other 3～7 days till the discharge from the hospital during Jan. 2005 to Aug. 2006. The severity of IVH was graded based on Papile classification for IVH. Results A total of 3768 premature infants were admitted to the 9 hospitals during the investigation. The overall incidences of IVH and severe IVH were 9.3% (352/3768) and 2.1% (78/3768), consisting of 23.3% (82/352)for grade Ⅰ, 54.5% (192/352) for grade Ⅱ, 17.6% (62/352) for grade Ⅲ and 4.5% (16/352) for grade Ⅳ, respectively. The overall incidences of IVH (5.1% vs. 14.1% ) and severe IVH (1.5% vs. 2.7% ) in 4 maternity and infant hospitals were significantly higher than those in five general or children's hospitals (X2=89.045, P=0.000; X2=6.909, P=0.009). The probable high-risk factors in the occurrence of severe IVH were premature rupture of the membrane, perinatal asphyxia, mechanical ventilation, twin or multiple pregnancies and amniotic fluid contamination. Conclusions The data of the multicenter investigation can basically reflect the situation of the occurrence of IVH in premature infants in major big cities of China. However, more than 60% of population in China lives in the rural area, it is possible that there is a higher incidence of IVH in premature infants than the results of the present survey owing to the limited medical condition in the rural area. Further muiticenter investigation in the rural area is expected to be undertaken in future.
