早产儿脑室内出血相关因素分析

Related factors analysis of intraventricular hemorrhage in premature infants

目的探讨早产儿脑室内出血(IVH)的相关高危因素。方法对2010年1月至2011年12月在西安高新医院分娩后收住新生儿病区及新生儿重症监护病房(NICU)的早产儿126例,根据床旁颅脑B超、临床诊断结果,将其分为脑室内出血组(72例)和无脑室内出血组(54例),并进行对比分析。结果①胎龄≤32周或体质量≤1500 g早产儿的脑室内出血发生率明显高于胎龄>32周或体质量>1500 g的早产儿(χ2=9.78,P<0.05;χ2=18.81,P<0.01)。②阴道分娩早产儿的脑室内出血发生率明显高于剖宫产者(χ2=13.21,P<0.01);存在高危因素早产儿的脑室内出血发生率明显高于无高危因素的早产儿(χ2=21.30,P<0.01)。③围生期窒息和机械通气等因素与早产儿脑室内出血密切相关。结论胎龄、出生体质量、分娩方式、围生期窒息、机械通气等是早产儿脑室内出血发生的高危因素;减少早产、低体质量儿的出生率,可有效降低脑室内出血的发生率和新生儿死亡率;颅脑B超可做为早产儿脑室内出血的筛查、早期诊断和跟踪随访的重要检查手段。

Objective To investigate the related high-risk factors of intraventricular hemorrhage（IVH） in premature infants. Methods From January 2009 to December 2011, a total of 126 premature infants were inspected with B cranial ultrasound tor intraventricular hemorrhage, and were divided into IVH group （72 cases） and non IVH group （54 cases）. Compared and analyzed the results. Results①The incidence of intraventricular hemorrhage in premature infants with gestational age ≤ 32 weeks or with birth weight ≤ 1500 grams was significantly higher than that in premature infants with gestational age 〉 32 weeks or with birth weight 〉 1500 grams （χ2 = 9.78 ,P 〈 0. 05;χ2 = 18.81 ,P 〈 0.01 ）. ②The incidence of IVH in premature infants with vaginal delivery was significantly higher than that in premature infants with cesarean section（ χ2 = 13.21 ,P 〈0.01 ） ; The incidence of IVH in premature infants with high risk factors was significantly higher than that in premature infants with no high risk factors （χ2 = 21.30 ,P 〈 0.01 ）.③IVH in premature infants was closely correlated with perinatal asphyxia and mechanical ventilation, etc. Conclusion Gestational age, birth weight, delivery pattern, perinatal asphyxia, mechanical ventilation are the risk factors of IVH in premature infants ; decreasing the birth rate of premature infants or low weight newborn can effectively reduce the incidence of intraventricular hemorrhage of newborn and the mortality of newborn ; the head ultrasound is one of the important methods which may be used to screen, early diagnose and follow-up the premature infants with intraventricular hemorrhage.