早产儿脑室周围-脑室内出血发生率及影响因素分析  

Analysis on Incidence and Its Affective Factors of Periventricular-Intraventricular Hemorrhageof Premature

作　　者：李德宝[1] 张燕[1] 张欢[1] 王书华[1] 高凤霞[1] 赵月霞[1] 

机构地区：[1]天津市塘沽区妇幼保健院,天津300451

出　　处：《黑龙江医学》2010年第1期10-12,共3页Heilongjiang Medical Journal

摘　　要：目的分析早产儿脑室周围-脑室内出血(Periventricular-Intraventricular Hemorrhage,PIHV)的发生率及影响发病的相关围产因素。方法选择2006-08～2009-05间,在我院出生后,并在我院新生儿病房住院的早产儿160例,并于生后1周内进行头颅超声检查,并记录相关围产因素。结果160例中,顺产110例,剖宫产50例。胎龄26～不足37周。其中,≤32周22例,33周14例,34周25例,≥35周99例。出生体质量1 050～3 650 g,≤1 500 g 9例,<2 000 g 21例,≥2 000 g 62例,≥2 500 g 68例。160例早产儿PIVH 51例,发生率31.9%。其中,Ⅰ级20.6%(33/160),Ⅱ级4.4%(7/160),Ⅲ级5.6%(9/160),Ⅳ级1.3%(2/160)。Ⅰ、Ⅱ级PIVH患儿多无明显的临床症状,Ⅲ级以上重度PIVH 11例占6.9%。胎龄<35周PIVH发生率为42.6%(26/61),显著高于胎龄≥35周的25.3%(25/99),具有围产高危因素的早产儿PIVH发生率高于无高危因素的早产儿,差异有统计学意义(P<0.05),且重度出血多为<35周的早产儿。产前应用地塞米松或生后应用猪肺表面活性物质与未应用患儿比较虽差异无统计学意义(P>0.05),但用药后,早产儿PIVH发生率降低。结论PIVH以胎龄<35周及具有围产高危因素的早产儿发生率为高,对早产儿生后常规进行头颅超声检查可早期发现无症状的PIVH患儿。Objective To analyze the Periventricular-Intraventricular Hemorrhage（PIVH） incidence and its affective factors.Methods 160 cases of premature newborn in our hosptal from August 2006 to May 2009 were detected with head ultrasound at 1 week and recorded relative factors peri-dilivery stage.Results There were 110 cases in normal labor,50 cases in U-D with fetal age from 26～37 weeks.Among them,there were 22 cases less than 32 weeks,14 cases in 33 weeks,25 cases in 34 weeks and 99 cases over 35 weeks.The body weight at birth was from 1 050～3 650 g,among them there were 9 cases less than 1 500 g,21 cases less than 2 000 g,62 cases more than 2 000 g,68 cases more than 2 500 g.The incidence was 31.9%（51/160） of PIVH,among them there was 20.6%inⅠdegree,4.4%inⅡdegree,5.6%inⅢdegree and 1.3%inⅣdegree.There was no manifestation in degreeⅠandⅡ.The incidence of PIVH of FA less than 35 weeks was 42.6%that more than those 25.3%whose FA more than 35 weeks.The PIVH of high risk factors of perinatal stage was higher than that without risk factors.There was no significant difference with poractant alfa and DM but incidence of PIVH was lowered. Conclusion PIVH incidence was higher in less than 35 weeks and high risk factors of perinatal stage.The head ultrasound detection might find the PIVH in early stage without symptoms.

关 键 词：早产儿 脑室周围-脑室内出血 发生率 头颅超声 

分 类 号：R722[医药卫生—儿科]