早产儿颅内出血的MRI表现特点及其危险因素

Characteristics of MRI and risk factors of intracranial hemorrhage in preterm infants

目的总结早产儿颅内出血的MRI表现特点,探讨颅内出血的危险因素。方法回顾性分析2016年1月至2018年12月首都医科大学附属北京友谊医院收治的668例早产儿(<37周)的病例资料,整理颅内出血的早产儿病例,分析MRI表现特点及早产儿颅内出血的危险因素。结果668例早产儿中,有40例发生颅内出血,发生率为6.0%。小于32周早产儿颅内出血的发生率为15.5%,出生体重<1000 g早产儿颅内出血发生率为28.6%。室管膜下/脑室内出血最多,其次为脑实质出血(小脑出血)。危险因素分析发现,不同胎龄、出生体重,是否窒息及机械通气颅内出血发生率差异具有统计学意义(P<0.05),而性别、剖宫产、母亲因素(妊娠期糖尿病、胎膜早破及先兆子痫)颅内出血发生率差异无统计学意义(P>0.05)。结论早产儿颅内出血最常见的类型为侧脑室出血及脑实质出血(小脑出血),胎龄、出生体重、窒息及机械通气是早产儿颅内出血的危险因素。

Objective To summarize the MRI characteristics of intracranial hemorrhage in preterm infants and explore the risk factors for intracranial hemorrhage.Methods A retrospective analysis was performed on 668 cases of preterm infants(gestational age<37w)in our hospital from January 2016 to December 2018.Then cases of premature infants with intracranial hemorrhage were sort out.The MRI characteristics the risk factors of intracranial hemorrhage in premature infants were analyzed.Results There are 40 cases of intracranial hemorrhage of all the 668 preterm infants.The incidence was 6.0%.But the incidence was 15.5%and 28.6%in cases with gestation age less than 32 weeks and birth weight less than 1000 g,respectively.The most common types of intracranial hemorrhage were subependymal hemorrhage/intraventricular hemorrhage,followed by intraparenchymal hemorrhage(cerebellar hemorrhage).Analysis of risk factors showed that the differences in the incidence of intracranial hemorrhage between different gestational ages,different birth weights and with or without asphyxia and mechanical ventilation were statistically significant(P<0.05),But there were no statistically significant differences in the incidence between different genders,cesarean section or not,and different maternal factors(gestational diabetes,premature rupture of membranes,preeclampsia)(P>0.05).Conclusion The most common types of intracranial hemorrhage in preterm infants are intraventricular hemorrhage and intraparenchymal hemorrhage(mainly cerebellar hemorrhage).The gestational age,birth weight,asphyxia and mechanical ventilation are the risk factors for intracranial hemorrhage in preterm infants.