足月儿颅内出血的发生情况、危险因素及其对远期生命质量的影响  

Incidence and risk factors for intracranial hemorrhage and its impact on long-term quality of life in term infants

作　　者：李曼曼 王伟 吴鸿波[1] 臧莉莉 赵晶晶 张迪[1] 李丽华[1] LI Man-man;WANG Wei;WU Hong-bo;ZANG Li-li;ZHAO Jing-jing;ZHANG Di;LI Li-hua(Children′s Center,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院儿童中心,北京市101149

出　　处：《广西医学》2022年第5期474-478,共5页Guangxi Medical Journal

基　　金：北京市教育委员会科技计划(KM201910025001)。

摘　　要：目的分析足月儿颅内出血的发生情况及危险因素,并探讨其对患儿远期生命质量的影响。方法纳入152例颅内出血足月儿(观察组),以及304例同期无颅内出血的健康足月儿(对照组)。收集两组新生儿及其母亲的临床资料。以电话随访的方式,采用儿童生命质量测定量表4.0中文版普适性核心量表对两组儿童的远期生命质量进行评定。分析足月儿发生脑室周围-脑室内出血(PV-IVH)或硬膜下出血(SDH)的危险因素。结果足月儿颅内出血的发生率为1.3%(152/12089),以PV-IVH为主要类型(占48.0%),SDH占35.5%。小于胎龄儿、宫内窘迫、产钳助产是足月儿发生PV-IVH的独立危险因素(均P<0.05);阴道分娩、产钳助产是足月儿发生SDH的独立危险因素(均P<0.05)。新生儿期合并颅内出血的儿童生命质量测定量表总均分、生理功能维度均分、情感功能维度均分及社交功能维度均分均低于正常儿童(均P<0.05)。结论足月儿颅内出血的发生率为1.3%,以PV-IVH为主要类型。小于胎龄儿、阴道分娩、产钳助产与宫内窘迫可增加足月儿颅内出血的发生风险。新生儿期合并颅内出血的儿童的远期生命质量差于正常儿童,生理功能、情感功能和社交功能均有受损。Objective To analyze the incidence and risk factors for intracranial hemorrhage(ICH)in term infants,and to explore its impact on infants′long-term quality of life.Methods A total of 152 term infants with ICH(observation group)as well as 304 concurrent healthy term infants without ICH(control group)were enrolled.The clinical data of neonates and their mothers were collected from the two groups.By means of telephone follow-up,an assessment on the long-term quality of life of the children in the two groups was performed using the Chinese version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales.The risk factors for developing periventricular-intraventricular hemorrhage(PV-IVH)or subdural hemorrhage(SDH)in term infants were analyzed.Results Term infants yielded an incidence rate of ICH of 1.3%(152/12089),of whom the majority suffered from PV-IVH(48.0%)and 35.5%had SDH.Small for gestational age,intrauterine distress,and forceps delivery were independent risk factors for developing PV-IVH in term infants(all P<0.05);transvaginal delivery and forceps delivery were independent risk factors for developing SDH in term infants(all P<0.05).Children with concomitant neonatal ICH yielded decreases in the total average score of the Pediatric Quality of Life Inventory,physiological function dimension average score,emotional function dimension average score,and social function dimension average score as compared with normal children(all P<0.05).Conclusion The incidence rate of ICH is 1.3%in term infants,with PV-IVH as the main type.Small for gestational age,transvaginal delivery,forceps delivery,and intrauterine distress might increase the risks for developing ICH in term infants.Children with concomitant neonatal ICH have a poorer long-term quality of life than normal children and sustain damage to physical,emotional and social functions.

关 键 词：足月儿 颅内出血 脑室周围-脑室内出血 硬膜下出血 危险因素 生命质量 

分 类 号：R722.151[医药卫生—儿科]