住院早产儿脑室内出血10年回顾性调查及影响因素分析

Incidence and risk factors of intraventricular hemorrhage in hospitalized premature infants during 10-year period

目的 调查住院早产儿脑室内出血 (IVH)发生率及其影响因素。方法 对 1993～ 2 0 0 2年 10年间入住新生儿病房、曾经头颅B超检查的所有住院早产儿进行分析 ,应用SIGMAB超诊断仪对早产儿进行床边头颅B超检查。结果 392例早产儿的平均胎龄为 (34 0± 2 1)周 ,平均出生体重为 (2 13± 0 5 3)kg。平均头颅B超初次检查时间为生后 (5 3± 6 3)d ,其中本院出生患儿为 (4 0± 2 0 )d ,外院出生患儿为 (7 0± 8 0 )d ,两者有非常显著性意义。总的IVH发生率为 5 6 6 % (2 2 2 / 392 ) ,重度IVH发生率为 16 3% (6 4 / 392 )。早产儿的胎龄愈小 ,出生体重愈低 ,其IVH发生率愈高 ,出血程度也趋严重。围产期窒息、家中自娩、机械通气、产妇为外来民工等因素与早产儿IVH及其出血程度密切相关。结论 鉴于早产儿IVH的高发生率及约一半IVH早产儿无明显临床症状 。

Objective To explore the incidence of intraventricular hemorrhage (IVH) and risk factors for IVH in hospitalized premature infants.Methods All clinical data were collected and analyzed in 392 hospitalized premature infants on whom the bedside cranial ultrasound had been undertaken in their early age after birth during Nov.1993 to Mar.2002.Results The average gestaional age of 392 infants was 34 0±2 1 weeks and average birthweight was 2 13±0 53kg.The initial bedside real time cranial sonogram was recorded was 5 3±6 3 days,in which utborn babies were significantly delayed [(7 0±8 0)d] than inborn invants [(4 0±2 0)d].The overall incidence of IVH was 56 6% (222/392) and the proportion of severe IVH was 16 3% (64/392).The well known inverse correlation between IVH and birthweight and gestational age were again demonstrated.The lower the birthweight was,the higher the incidence of IVH would be,and the hemorrhage tended towarkds serious.IVH occurred more often in infants with perinatal asphyxia,delivery at home and mechanical ventilation,etc.in particular there was a marked correlation between IVH and infants whose mothers were non regular laborers with poor prenatal care.Conclusion Since there is a higher incidence of IVH in premature infants and nearly half cases among them were usually no obvious symptom clinically,it is suggested that a routine examination of cranial ultrasound be necessary for each premature infant at their early age.