早产儿脑白质损伤发病率及高危因素分析

Analysis of the incidence rate and risk factors of premature white matter injury

目的:探讨早产儿脑白质损伤发病率及高危因素。方法:选取早产儿568例,对其胎龄、出生体质量等相关因素进行分析,探究早产儿脑白质损伤发病情况以及其高危影响因素。结果:早产儿脑白质损伤发病率22.2%,在胎龄方面,胎龄<28周早产儿脑白质损伤发生率最高;在体质量方面,出生体质量<1.0 kg早产儿脑白质损伤发生率最高;单因素分析显示败血症、低氧血症、机械通气、先兆早产、宫内感染、宫内窘迫、酸中毒、窒息史、妊娠期高血压、产前激素、胎龄以及出生时体质量均对脑白质损伤存在明显影响(P<0.05);多因素回归分析显示,孕期感染、窒息史、剖宫产以及酸中毒属于脑白质损伤发生的独立危险因素(P<0.05)。结论:早产儿胎龄越低、出生体质量越低,发生脑白质损伤的概率越高,且孕期感染、窒息史、剖宫产以及酸中毒属于脑白质损伤发生的独立危险因素。

Objective:To investigate the incidence rate and risk factors of premature white matter injury.Methods:The gestational age and birth weight of 568 premature infants were analyzed,and the incidence rate of premature white matter injury and its high-risk factors were investigated.Results:The incidence rate of white matter injury in premature infants was 22.2%.In terms of gestational age,the incidence rate of white matter injury in premature infants with gestational age<28 weeks was the highest.In terms of body mass,the incidence rate of white matter injury in preterm infants with birth weight less than 1.0 kg was the highest.The results of univariate analysis showed that the sepsis,hypoxemia,mechanical ventilation,threatened preterm delivery,intrauterine infection,intrauterine distress,acidosis,history of asphyxia,high blood pressure during pregnancy,prenatal hormones,gestational age and body weight at birth significantly affected the brain white matter injury(P<0.05).The results of multivariate regression analysis showed that infection during pregnancy,history of asphyxia,cesarean section,and acidosis were the independent risk factors of the occurrence of white matter injury(P<0.05).Conclusions:The lower the gestational age is,the lower the birth weight of premature infants is,and the higher the probability of white matter injury is.The infection during pregnancy,asphyxia history,cesarean section and acidosis are the independent risk factors of white matter injury.