极早产儿脑损伤的危险因素及临床表现分析  

Risk factors and clinical manifestations of brain injury in very prematur e infants

作　　者：梁伟怡 陆镇奇[1] 李炜基 LIANG Weiyi;LU Zhenqi;LI Weiji(Foshan Maternal and Child Health Care Hospital,Foshan Guangdong 528000)

机构地区：[1]佛山市妇幼保健院,广东佛山528000

出　　处：《当代医药论丛》2023年第12期57-59,共3页

基　　金：佛山市卫生健康局医学科研课题,项目名称:极早产儿脑损伤风险因素分析及临床预测模型的构建与效能评估,课题编号:20220024。

摘　　要：目的:本文将对极早产儿脑损伤的危险因素进行探讨,并对发生脑损伤和未发生脑损伤极早产儿的临床特征进行比较研究。方法:对2020年3月至2022年1月在佛山市妇幼保健院新生儿科住院的218例符合入选标准的极早产儿的临床资料进行回顾性分析。将其分为脑损伤组(187例)和无脑损伤组(31例)。本研究通过Logistic回归分析对危险因素进行研究,并对两组极早产儿的临床特征进行分析。结果:(1)单因素分析提示极早产儿发生脑损伤的危险因素如下:产前未应用硫酸镁、应用血管活性药物、感染、窒息、低出生体重,相关差异均具有统计学意义(P<0.05)。胎膜早破、胎盘异常、脐带异常、分娩胎数、分娩方式情况的组间差异均无统计学意义(P>0.05)。(2)将具有统计学意义的单因素纳入到多因素Logistic回归分析中,分析结果显示,产前未应用硫酸镁、应用血管活性药物、窒息是极早产儿发生脑损伤的独立危险因素。(3)脑损伤组与无脑损伤组患儿合并疾病情况及临床表现的差异无统计学意义(P>0.05)。结论:产前未应用硫酸镁、应用血管活性药物、窒息是极早产儿发生脑损伤的独立危险因素,需尽早对存在上述危险因素的极早产儿进行干预和随访,以改善其神经系统预后,促进其脑发育。Objective:In this paper,the risk factors of brain injury in very premature infants were discussed,and the clinical characteristics of very premature infants with and without brain injury were compared.Methods:The clinical data of 218 extremely premature infants who met the inclusion criteria and were hospitalized in the Neonatology Department of Foshan Maternal and Child Health Hospital from March 2020 to January 2022 were retrospectively analyzed.The patients were divided into brain injury group(187 cases)and no brain injury group(31 cases).In this study,the risk factors were studied by Logistic regression analysis,and the clinical characteristics of two groups of very premature infants were analyzed.Results:(1)Univariate analysis suggested that the risk factors of brain injury in very premature infants were as follows:no prenatal application of magnesium sulfate,application of vasoactive drugs,infection,asphyxia,low birth weight,and the relevant differences were statistically significant(P<0.05).There were no significant differences in premature rupture of membranes,abnormal placenta,abnormal umbilical cord,number of parturients and mode of parturience among groups(P>0.05).(2)The single factor with statistical significance was included in the multivariate Logistic regression analysis,and the analysis results showed that the absence of prenatal magnesium sulfate,the application of vasoactive drugs and asphyxia were independent risk factors for brain injury in very premature infants.(3)There was no significant difference in the combined diseases and clinical manifestations between the brain injury group and the non-brain injury group(P>0.05).Conclusion:No prenatal application of magnesium sulfate,application of vasoactive drugs and asphyxia are independent risk factors for brain injury in very premature infants.Early intervention and follow-up should be carried out in very premature infants with these risk factors to improve their nervous system prognosis and promote their brain development.

关 键 词：极早产儿 脑损伤 神经发育 危险因素 

分 类 号：R72[医药卫生—儿科]