新生儿脑损伤危险因素分析

Analysis of risk factors for neonatal brain injury

目的探讨新生儿发生脑损伤的危险因素,为临床减少脑损伤的发生以及早发现、早治疗提供临床依据。方法选取潍坊市妇幼保健院2014年2月~2016年2月收治的新生儿320例为研究对象,搜集新生儿临床资料及产妇资料,所有产妇均在分娩后立即取胎盘、胎膜送本院病理科行病理检查,新生儿均在出生后2周内行头颅磁共振检查,根据检查结果将研究对象分为脑损伤组(n=111)和非脑损伤组(n=209),应用卡方检验及Logistic分析研究新生儿脑损伤发生的危险因素。结果宫内感染程度越重,新生儿脑损伤发生率越高,小胎龄组、低出生体重组、新生儿呼吸窘迫综合征(NRDS)组、胎儿窘迫组、新生儿窒息组脑损伤发生率明显高于足月儿组、正常出生体重组、非NRDS组、非胎儿窘迫组、非窒息组,差异有统计学意义。结论宫内感染可导致新生儿不良结局,影响新生儿预后;胎儿窘迫、小胎龄、新生儿窒息、NRDS、低出生体重可增加新生儿脑损伤的风险。

Objective To explore the risk factors of brain injury in neonates,and to provide clinical basis for clinical reduction of brain injury,early detection and early treatment. Methods A total of 320 newborns were selected from February 2014 to February 2016 in Weifang maternity and child care hospital. The placenta was taken after childbirth and the embryolemma was sent to the pathology department for pathological examination. The brain magnetic resonance imaging of all neonates were performed at 2 weeks after birth,and,all neonates were divided into brain injury group and non brain injury group according to the MRI results. The risk factors of neonatal brain injury were performed by chi square test and logistic analysis. Results The incidence of neonatal brain injury increased as the degree increase of intrauterine infection. The incidence of neonatal brain injury in small gestational age group,low birth weight group,respiratory distress syndrome of newborn（ NRDS） group,fetal distress group,neonatal asphyxia group,and neonatal brain injury group were significantly higher than that in full-term infants group,the date was statistically significant. Conclusion Intrauterine infection can lead to neonatal brain injury. Fetal distress,small gestational age,neonatal asphyxia,NRDS,low birth weight can increase the risk of neonatal brain damage.