极早早产儿重度脑室内出血的危险因素分析  

Analysis of risk factors for severe intraventricular hemorrhage in extremely premature infants

作　　者：王永 徐昊冉 李克难 张姗 丁雪 徐发林[1] Wang Yong;Xu Haoran;Li Kenan;Zhang Shan;Ding Xue;Xu Falin(Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;School of Basic Medical Scienees,Zhengzhou University,Zhengzhou 450001,China)

机构地区：[1]郑州大学第三附属医院新生儿科,河南郑州450052 [2]郑州大学基础医学院,河南郑州450001

出　　处：《河南医学研究》2018年第14期2514-2516,共3页Henan Medical Research

摘　　要：目的探讨极早早产儿重度脑室内出血(IVH)的危险因素。方法选择2014年7月至2016年10月于郑州大学第三附属医院新生儿科重症监护室(NICU)住院的1 049例极早早产儿(EPI),生后3 d内行头颅彩超检查并根据Papile分级法对IVH进行分级。回顾性分析新生儿胎龄、出生体质量、性别、分娩方式、重度窒息史、机械通气史等因素与患儿是否发生严重IVH的关系。结果 1 049例胎龄<32周患儿中,无脑室内出血617例(58.8%),轻度(Ⅰ~Ⅱ级)脑室内出血379例(36.1%),重度(Ⅲ~Ⅳ级)脑室内出血53例(5.1%)。Logistic回归结果显示,性别、重度窒息史、机械通气史、经阴道分娩与胎龄<32周早产儿严重IVH相关(P<0.05)。结论性别、重度窒息史、机械通气史、经阴道分娩是胎龄<32周早产儿严重IVH的独立危险因素。如早产儿有上述危险因素,应及时采取针对性的预防措施,以降低重度IVH的发生率。Objective To explore the risk factors of severe intraventricular hemorrhage （IVH） in extremely premature in- fants. Methods From July 2014 to October 2016, 1 049 premature infants were treated at neonatal intensive care unit （NICU） in the Third Affiliated Hospital of Zheng Zhou University- were analyzed retrospectively. Children were classified into four different levels from grade [ to grade IV according to Papile. The perinatal high - risk factors of gestational age, birth weight, sex, mode of delivery-, history- of severe asphyxia, history- of mechanical ventilation, etc were Analyzed. Results Of the 1 049 children with gestational age less than 32 weeks, 617 cases had no IVH（58.8% ）, 379 cases had mild （ I - lI ） IVH （36. 1% ）, 53 cases had severe （]]I - IV ）IVH（5.1% ）. Logistic regression analysis showed that gender, mechanical ventilation history-, severe as- phyxia history-, vaginal delivery- were significantly correlated with severe IVH （ P 〈 0. 05 ）. Conclusion Gender, history- of se- vere asphyxia, history- of mechanical ventilation and vaginal delivery- are independent risk factors for severe IVH in premature in- fants with gestational age less than 32 weeks. In order to reduce the incidence of severe IVH, preventive measures should be taken in time after the occurrence of the above risk factors during the treatment of premature infants.

关 键 词：极早早产儿 头颅彩超 脑室内出血 危险因素 

分 类 号：R722.15[医药卫生—儿科]