中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2014年
2期
226-228
,共3页
早产儿%脑室周围-脑室内出血%颅脑B超%高危因素
早產兒%腦室週圍-腦室內齣血%顱腦B超%高危因素
조산인%뇌실주위-뇌실내출혈%로뇌B초%고위인소
premature infant%periventricular-intraventricular hemorrhage ( PIVH)%head B-ultrasound%high-risk factor
目的：探讨早产儿脑室周围-脑室内出血（ PIVH）的高危因素。方法对2010年1月至2011年12月期间，在西安高新医院分娩后收住新生儿病区及新生儿重症监护室的早产儿126例，根据床旁颅脑B超、临床诊断结果分为脑室内出血组（72例）和无脑室内出血组（54例），并进行对比分析。结果126例早产儿中脑室周围-脑室内出血发生率为57．1％（72/126），其中重度PIVH发生率29．2％（21/72）。胎龄≤32周或体重≤1500g的早产儿PIVH的发生率明显高于胎龄＞32周或体重＞1500g的早产儿，差异有统计学意义（χ2值分别为18．81和9．78，均P＜0．05）。与无PIVH组相比，PIVH组患儿在宫内窘迫（20例vs 10例）、新生儿呼吸窘迫综合征（18例vs 7例）、血小板减少（12例vs 4例）、生后感染（23例vs 11例）等方面比较，差异有统计学意义（χ2值分别为8．10、5．62、11．23、13．40，均P＜0．05）。 Logistic回归分析结果显示胎龄≤32w、窒息、机械通气、血小板减少、生后感染是发生PIVH的危险因素。结论早产儿脑室周围-脑室内出血与胎龄、出生体重、窒息程度、机械通气、宫内窘迫、血小板减少和生后感染等因素相关；加强产前监护、提高产科技术，综合防治可减少PIVH发生，提高早产儿抢救成功率，减少后遗症的发生。
目的：探討早產兒腦室週圍-腦室內齣血（ PIVH）的高危因素。方法對2010年1月至2011年12月期間，在西安高新醫院分娩後收住新生兒病區及新生兒重癥鑑護室的早產兒126例，根據床徬顱腦B超、臨床診斷結果分為腦室內齣血組（72例）和無腦室內齣血組（54例），併進行對比分析。結果126例早產兒中腦室週圍-腦室內齣血髮生率為57．1％（72/126），其中重度PIVH髮生率29．2％（21/72）。胎齡≤32週或體重≤1500g的早產兒PIVH的髮生率明顯高于胎齡＞32週或體重＞1500g的早產兒，差異有統計學意義（χ2值分彆為18．81和9．78，均P＜0．05）。與無PIVH組相比，PIVH組患兒在宮內窘迫（20例vs 10例）、新生兒呼吸窘迫綜閤徵（18例vs 7例）、血小闆減少（12例vs 4例）、生後感染（23例vs 11例）等方麵比較，差異有統計學意義（χ2值分彆為8．10、5．62、11．23、13．40，均P＜0．05）。 Logistic迴歸分析結果顯示胎齡≤32w、窒息、機械通氣、血小闆減少、生後感染是髮生PIVH的危險因素。結論早產兒腦室週圍-腦室內齣血與胎齡、齣生體重、窒息程度、機械通氣、宮內窘迫、血小闆減少和生後感染等因素相關；加彊產前鑑護、提高產科技術，綜閤防治可減少PIVH髮生，提高早產兒搶救成功率，減少後遺癥的髮生。
목적：탐토조산인뇌실주위-뇌실내출혈（ PIVH）적고위인소。방법대2010년1월지2011년12월기간，재서안고신의원분면후수주신생인병구급신생인중증감호실적조산인126례，근거상방로뇌B초、림상진단결과분위뇌실내출혈조（72례）화무뇌실내출혈조（54례），병진행대비분석。결과126례조산인중뇌실주위-뇌실내출혈발생솔위57．1％（72/126），기중중도PIVH발생솔29．2％（21/72）。태령≤32주혹체중≤1500g적조산인PIVH적발생솔명현고우태령＞32주혹체중＞1500g적조산인，차이유통계학의의（χ2치분별위18．81화9．78，균P＜0．05）。여무PIVH조상비，PIVH조환인재궁내군박（20례vs 10례）、신생인호흡군박종합정（18례vs 7례）、혈소판감소（12례vs 4례）、생후감염（23례vs 11례）등방면비교，차이유통계학의의（χ2치분별위8．10、5．62、11．23、13．40，균P＜0．05）。 Logistic회귀분석결과현시태령≤32w、질식、궤계통기、혈소판감소、생후감염시발생PIVH적위험인소。결론조산인뇌실주위-뇌실내출혈여태령、출생체중、질식정도、궤계통기、궁내군박、혈소판감소화생후감염등인소상관；가강산전감호、제고산과기술，종합방치가감소PIVH발생，제고조산인창구성공솔，감소후유증적발생。
Objective To explore the high risk factors of periventricular-intraventricular hemorrhage ( PIVH ) in premature infants . Methods A total of 126 premature infants admitted in neonates ward and NICU during the period of January 2010 to December 2011 in Xi’an Hi-Tech Park Hospital were divided into intraventricular group (n=72) and non PIVH group (n=54) according to 2D cranial ultrasonography and clinical diagnosis results .The results were compared .Results The incidence rate of PIVH among 126 premature infants was 57.1%(72/126), of which 29.2%(21/72) were severe cases.The incidence rate of PIVH among premature infants with gestational age ≤32 weeks or birth weight ≤1500 grams was significantly higher than that with gestational age >32 weeks or birth weight>1 500 grams (χ2 value was 18.81 and 9.78, respectively, both P<0.05).Compared with the infants without PIVH , the differences in fetal distress (20 cases vs 10 cases), NRDS (18 cases vs 7 cases), thrombocytopenia (12 cases vs 4 cases) and postnatal infection (23 cases vs 11 cases) were statistically significant (χ2 value was 8.10, 5.62, 11.23 and 13.40, respectively, all P<0.05).Logistics regression analysis revealed that PIVH occurrence in infants was more closely related with such factors as gestational age ≤32w, asphyxia, mechanical ventilation , thrombocytopenia and postnatal infection .Conclusion Occurrence of PIVH is associated with such factors as gestational age, birth weight, asphyxia, mechanical ventilation, fetal distress, thrombocytopenia as well as postnatal infection . Strengthening prenatal care , improving obstetric techniques and integrated prevention can reduce the occurrence of PIVH , improve the survival rate of preterm infants and reduce the incidence of complications .
