NICU极低体重早产儿脑损伤影响因素分析

Analysis of the factors affecting brain injury in NICU premature infants with very low weight

目的探究影响NICU极低体重早产儿脑损伤的相关因素。方法回顾性分析2014年1月—2017年1月收治的163例极低体重早产儿临床资料,根据脑损伤情况分为脑损伤组(66例)和非脑损伤组(97例),比较两组产妇、早产儿一般资料并分析相关影响因素,计数资料比较采用χ2检验,影响因素采用Logistic回归分析,P<0.05为差异有统计学意义。结果产妇无激素用药史、患有绒毛膜羊膜炎者极低体重早产儿脑损伤率较高(均P<0.05);呼吸暂停、窒息、肺出血者、低氧血症、血小板减少、酸中毒、动脉导管未闭、低碳酸血症是脑损伤影响因素(均P<0.05)。Logistic回归分析发现产妇产前激素用药史是极低体重早产儿脑损伤的保护因素(P<0.05),产妇发生绒毛膜羊膜炎及患儿合并窒息、酸中毒、动脉导管未闭是极低体重早产儿脑损伤的危险因素(均P<0.05)。结论极低体重早产儿脑损伤影响因素包括产妇产前激素用药史、产妇发生绒毛膜羊膜炎及患儿合并窒息、酸中毒、动脉导管未闭。

Objective To explore the related factors affecting the brain damage in premature infants with very low weight in NICU. Methods A total of 163 cases of very low weight preterm infants admitted to the hospital from January 2014 to January 2017 were retrospectively analyzed. According to the brain injury cases, the patients were divided into brain injury group（66 cases） and non-brain injury group（97 cases）. Compare the general data of the two groups of mothers and premature infants and analyze the related factors. Enumeration data were compared by χ2 test, influencing factors were analysed by Logistic regression.P〈0.05 was considered statistically significant.Result The incidence of brain injury was very high in the very low birth weight premature infants who had maternal history of no steroid use or chorioamnionitis. Apnea, asphyxia, pulmonary hemorrhage, hypoxemia, thrombocytopenia, acidosis, patent ductus arteriosus, hypocapnia are the factors affecting the brain injury（all P〈0.05）.Logistic regression analysis showed that the maternal history of steroid use was a protective factor for brain damage in very low birth weight premature infants（P〈0.05）.Maternal chorioamnionitis and asphyxia, acidosis and patent ductus arteriosus are risk factors for brain injury in very low birth weight premature infants（all P〈0.05）.Conclusion The risk factors of brain injury in very low weight premature infants include the maternal history of no steroid use or chorioamnionitis, asphyxia, acidosis and patent ductus arteriosus in children.