早产儿脑损伤早期相关高危因素分析

Analysis of early high-risk factors of brain injury in preterm infants

目的分析早产儿产前、产中及产后各因素对神经系统预后的影响。方法回顾性分析该院新生儿重症监护病房(NICU)2014年12月-2016年6月住院的患儿,其中选择符合诊断标准的早产儿脑损伤病例45例作为实验组,50例无脑损伤早产儿为对照组,收集并分析所有病例的相关危险因素。结果分别比较两组间产前及产时各因素的差异,其中母亲患有绒毛膜羊膜炎的患儿比较差异有统计学意义(χ~2=6.521,P<0.05),而母亲患妊娠期高血压疾病、妊娠期糖尿病的早产儿以及分娩方式(剖宫产)的比较,差异无统计学意义(χ~2=3.790、0.176、0.657,均P>0.05);分别比较两组间产后各因素的差异,其中患有败血症(χ~2=4.679)以及低血糖(t=-2.73)的患儿比较差异有统计学意义(均P<0.05),且两组间正压通气时间和5 min Apgar评分的比较差异有统计学意义(t=2.21、5.52,均P<0.05),而患儿入院体温的比较,差异无统计学意义(t=-1.67,P>0.05)。结论其母患绒毛膜羊膜炎,患儿患败血症、低血糖以及Apgar评分低,机械通气时间长都是早产儿脑损伤的早期危险因素。

Objective To analyze the effect of various factors on neurological prognosis of preterm infants before,during,and after birth.Methods The preterm infants in NICU of the hospital from December 2014 to June 2016 were retrospectively analyzed and divided into experimental group（45 infants with brain injury） and control group（50 infants without brain injury）,the related risk factors were collected.Results There was significant difference in the proportion of infants whose mothers suffered from chorioamnionitis between the two groups（χ^2= 6.521,P〉0.05）.There was no significant difference in the proportion of infants whose mothers suffered from hypertensive disorder complicating pregnancy,gestational diabetes mellitus and cesarean section between the two groups（χ^2= 3.790,0.176,0.657,P〈0.05）.There were significant differences in the proportions of infants with sepsis and hypoglycemia,positive pressure ventilation time,and Apgar score between the two groups（χ^2= 4.679,-2.73,P〈0.05;t = 2.21,5.52,P〈0.05）.There was no significant difference in body temperature of the infants at admission between the two groups（t =-1.67,P〉0.05）.Conclusion Maternal chorioamnionitis,infantile sepsis,hypoglycemia,low Apgar score,and long mechanical ventilation time are early risk factors of brain injury in preterm infants.