34周以下早产儿颅内出血的危险因素分析  

Risk factors of intracranial hemorrhage in premature infants with gestational age less than 34 weeks

作　　者：王海如 张又祥[1] 欧巧群[1] 罗梅娟[1] 林泽璇 Wang Hairu;Zhang Youxiang;Ou Qiaoqun;Luo Meijuan;Lin Zexuan(Department of Pediatrics,Guangzhou First People's Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院儿科,广州510180

出　　处：《国际医药卫生导报》2022年第14期2023-2027,共5页International Medicine and Health Guidance News

摘　　要：目的探讨34周以下早产儿颅内出血的危险因素。方法选取2016年1月至2021年12月广州市第一人民医院新生儿重症监护病房收治的187例胎龄<34周早产儿的临床资料进行分析,其中把胎龄<34周影像学提示颅内出血的早产儿53例为颅内出血组,同期住院胎龄<34周影像学未提示颅内出血的早产儿134例为对照组。收集两组早产儿的临床资料进行回顾性研究,采用单因素分析[独立样本t检验、χ^(2)检验、Fisher确切概率法]及多因素logistic回归分析分析早产儿颅内出血的危险因素。结果颅内出血组中男26例、女27例,胎龄(30.22±2.31)周;对照组男70例、女64例,胎龄(32.04±1.49)周。单因素分析显示,两组剖宫产、孕母≥35岁、试管婴儿、双胎、羊水污染、妊娠期糖尿病、妊娠期高血压、胎盘早剥、胎膜早破、前置胎盘比率比较差异均无统计学意义(均P>0.05);颅内出血组胎龄<30周、体质量<1.5 kg、产前合并绒毛膜羊膜炎、宫内窘迫、宫内感染、出生Apgar评分≤7分、新生儿呼吸窘迫综合征、动脉导管未闭、机械通气、肺出血、血小板计数(PLT)<150×10^(9)/L比例分别为43.40%(23/53)、58.49%(31/53)、50.94%(27/53)、43.40%(23/53)、28.30%(15/53)、47.17%(25/53)、83.02%(44/53)、52.83%(28/53)、84.91%(45/53)、11.32%(6/53)、16.98%(9/53),均高于对照组的10.45%(14/134)、30.60%(41/134)、34.33%(46/134)、8.21%(11/134)、12.69%(17/134)、20.15%(27/134)、58.21%(78/134)、26.12%(35/134)、55.22%(74/134)、1.49%(2/134)、0.75%(1/134),差异均有统计学意义(均P<0.05);颅内出血组产前硫酸镁、地塞米松使用率分别为60.38%(32/53)、49.06%(26/53),均低于对照组的85.82%(115/134)、71.64%(96/134),差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,胎龄<30周、宫内感染、宫内窘迫、PLT<150×10^(9)/L为早产儿颅内出血的独立危险因素,产前使用硫酸镁是早产儿颅内出血的独立保护因素(均P<0.05)�Objective To analyze the risk factors of intracranial hemorrhage in premature infants with gestational age less than 34 weeks.Methods The clinical data of 187 premature infants with gestational age less than 34 weeks who were hospitalized in neonatal intensive care unit(NICU)of Guangzhou First People's Hospital from January 2016 to December 2021 were selected for analysis.Fifty-three premature infants with gestational age<34 weeks whose imaging findings indicated intracranial hemorrhage were selected as a intracranial hemorrhage group,and 134 premature infants with gestational age<34 weeks whose imaging findings did not indicate intracranial hemorrhage were selected as a control group.The clinical data of the two groups were collected for a retrospective study.Univariate analysis[independent sample t test,χ^(2) test,and Fisher's exact probability method]and multivariate logistic regression analysis were used to analyze the risk factors for intracranial hemorrhage in premature infants.Results In the intracranial hemorrhage group,there were 26 males and 27 females,with a gestational age of(30.22±2.31)weeks;in the control group,there were 70 males and 64 females,with a gestational age of(32.04±1.49)weeks.Univariate analysis showed that there were no statistically significant differences in the rates of cesarean section,mother≥35 years old,test tube baby,twins,amniotic fluid contamination,gestational diabetes,gestational hypertension,placental abruption,premature rupture of membrane,and placenta previa between the two groups(all P>0.05);the rates of gestational age<30 weeks,body weight<1.5 kg,prenatal chorioamnionitis,intrauterine distress,intrauterine infection,Apgar score≤7 at birth,neonatal respiratory distress syndrome,patent ductus arteriosus,mechanical ventilation,pulmonary hemorrhage,and platelet count(PLT)<150×10^(9)/L in the intracranial hemorrhage group were 43.40%(23/53),58.49%(31/53),50.94%(27/53),43.40%(23/53),28.30%(15/53),47.17%(25/53),83.02%(44/53),52.83%(28/53),84.91%(45/53),11.32%(6/53),and

关 键 词：早产儿 颅内出血 危险因素 

分 类 号：R722.6[医药卫生—儿科]