双胎早产儿脑损伤危险因素的配对分析

Paired analysis of risk factors for brain injury in premature twins

目的:分析早产儿脑损伤危险因素及临床特征。方法:回顾性分析配对双胎早产儿脑损伤组与无脑损伤组产前因素、围产期因素、出生后体质量增长、检验指标、并发症及治疗措施。结果:共纳入43对双胎早产儿。两组间产前、围产期情况及检验结果无统计学意义;脑损伤组新生儿呼吸窘迫综合征、支气管肺发育不良、贫血发生率及枸橼酸咖啡因、静脉营养、氧疗、输注红细胞、限制级抗生素使用率较无脑损伤组高(均为P>0.05);脑损伤组出生后住院期间日均体质量增长中位数为5.8(-4.6,14.5)g,低于无脑损伤组[12.9(3.8,18.7)g],而生后感染发生率(60.5%)、新生儿呼吸窘迫综合征分级、肺表面活性物质使用率(48.8%)及机械通气时间高于无脑损伤组(均为P<0.05)。结论:早产儿生后日均体质量增长慢、出生后感染、新生儿呼吸窘迫综合征分级高为早产儿脑损伤的危险因素。

Objective:To analyze the risk factors and clinical features of brain injury in premature infants.Methods:The prenatal factors,perinatal factors,postnatal weight gain,blood indexes,complications,and treatment measures between brain injury group and non-brain injury in twin premature infants were analyzed retrospectively.Results:A total of 43 pairs of premature twins were included.There was no significant difference in prenatal,perinatal,and postnatal routine tests between the two groups.The incidences of neonatal respiratory distress syndrome(NRDS),bronchopulmonary dysplasia,anemia,and the rates for caffeine citrate usage,intravenous nutrition,oxygen therapy,red blood cell transfusion,and restricted antibiotics in the brain injury group were higher than those in the nonbrain injury group(all P>0.05).The median daily weight gain during hospitalization in the brain injury group was was 5.8(-4.6,14.5)g,which was significantly lessthan 2.9(3.8,18.7)g in the non brain injury group,while the occurrence of postnatal infection(60.5%),grade of NRDS,the utiliza"tion rate of pulmonary surfactant(48.8%),and mechanical ventilation time in the brain injury group were higher or longer than those in the non-brain injury group(all P<0.05).Conclusion:Slow daily weight gain,postnatal infection,and high grade of NRDS are the risk factors of brain injury in premature infants.