不足32周早产儿颅内出血的临床分析  

Clinical analysis of primary intraventricular hemorrhage in preterm infants less than 32 weeks old

作　　者：李展莉 薛茹 王玮 贾丽丽 赵金章 刘丽 LI Zhanli;XUE Ru;WANG Wei;JIA Lili;ZHAO Jinzhang;LIU Li(Department of Neonatology,Xi'an People's Hospital,Shaanxi Xi'an 710004,China;Department of Neonatology,Northwest Women’s and Children's Hospital,Shaanxi Xi'an 710061,China;Department of Pediatrics,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710065,China)

机构地区：[1]西安市人民医院新生儿科,陕西西安710004 [2]西北妇女儿童医院新生儿科,陕西西安710061 [3]西安交通大学第一附属医院儿科,陕西西安710065

出　　处：《中国妇幼健康研究》2022年第4期82-86,共5页Chinese Journal of Woman and Child Health Research

基　　金：陕西省自然科学基础研究计划青年项目(S2021-JC-QN-1852)。

摘　　要：目的探讨小于32周早产儿颅内出血(PIVH)的发生情况及相关因素。方法选取2019年10月至2020年11月本院新生儿重症医学科收治的85例小于32周早产儿为研究对象,动态观察其住院期间颅脑B超检查情况。根据是否发生PIVH,将其分为观察组和对照组,比较两组患儿的基本临床特征、妊娠分娩因素间的差异,以及轻、重度PIVH患儿的妊娠分娩因素差异。结果小于32周早产儿住院期间发生PIVH者44例(51.76%),其中轻度33例,重度11例。观察组和对照组患儿在出生体重、胎龄、孕妇妊娠高血压、胎膜早破、新生儿窒息、动脉导管未闭(PDA)和机械通气方面的差异有统计学意义(χ^(2)值分别是4.202、5.141、4.121、4.873、4.320、15.883、28.334,P<0.05)。轻、重度PIVH组患儿新生儿窒息方面的差异有统计学意义(χ^(2)=7.281,P<0.05).结论早产儿胎龄越小、出生体重越低,发生PIVH的可能性越大;孕妇妊娠高血压、胎膜早破、新生儿窒息、PDA、机械通气也可影响PIVH的发生。建议加强产前健康宣教,尽早排查危险因素,并采取针对性干预措施,以预防早产儿PIVH发生,提高早产儿生存质量。Objective To investigate the occurrence and related factors of primary intraventricular hemorrhage(PIVH)in preterm infants less than 32 weeks.Methods From October 2019 to November 2020,85 preterm infants less than 32 weeks old who were admitted to the department of neonatal intensive care medicine of our hospital were selected as the research objects,and their brain B-ultrasound examinations during hospitalization were dynamically observed.According to whether PIVH occurred or not,they were divided into observation group and control group.The differences in basic clinical characteristics,pregnancy and delivery factors,and pregnancy and delivery factors between children with mild and severe PIVH were compared between the two groups.Results PIVH occurred 44 cases(51.76%)in preterm infants less than 32 weeks old during hospitalization,including 33 cases of mild and 11 cases of severe.There were significant differences in birth weight,gestational age,gestational hypertension,premature rupture of membranes,neonatal asphyxia,patent ductus arteriosus(PDA)and mechanical ventilation between the observation group and the control group(χ^(2)values were 4.202,5.141,4.121,4.873,4.320,15.883,28.334,respectively,P<0.05).There was a statistically significant difference in neonatal asphyxia between the mild and severe PIVH groups(χ^(2)=7.281,P<0.05).Conclusion The younger the gestational age and the lower the birth weight of the preterm infant,the greater the possibility of PIVH.Pregnancy hypertension,premature rupture of membranes,neonatal asphyxia,PDA and mechanical ventilation can also affect the occurrence of PIVH.It is suggested to strengthen prenatal health education,identify risk factors as soon as possible,and take targeted interventions to prevent the occurrence of PIVH in preterm infants and improve the quality of survival of preterm infants.

关 键 词：早产儿 颅内出血 危险因素 分娩因素 

分 类 号：R174.6[医药卫生—妇幼卫生保健]