早产儿颅脑超声检查1577例分析

Analysis of 1577 cases of premature infants with cranial ultrasound

目的 通过早产儿颅脑超声(CUS)检查结果 ,探讨早产儿脑损伤(BIPI)与胎龄及出生体重的关系。方法 回顾性分析1577例早产儿的临床资料,所有早产儿均行颅脑超声检查,分析颅脑超声检查结果 ,比较不同出生胎龄、出生体重早产儿脑损伤发生率。结果 1577例早产儿中颅脑超声发现脑损伤328例,其中单纯脑室周围-脑室内出血(PIVH)226例,单纯脑室周围白质软化(PVL)79例,同时发生PIVH与PVL 23例;其他轻度异常84例;正常1165例。出生胎龄≤30、31~32、33~34、35~36周早产儿的脑损伤发生率分别为39.06%(50/128)、25.13%(48/191)、19.88%(101/508)、17.20%(129/750),随着出生胎龄增加早产儿脑损伤的发生率逐渐降低。不同出生胎龄早产儿的脑损伤发生率比较,差异有统计学意义(P<0.05);不同出生胎龄早产儿脑损伤发生率两两比较差异均无统计学意义(P>0.05);不同出生胎龄早产儿轻度脑损伤发生率两两比较差异均无统计学意义(P>0.05);出生胎龄≤32周早产儿重度脑损伤发生率2.51%(8/319)明显高于出生胎龄>32周早产儿的0.08%(1/1258),差异有统计学意义(P<0.05)。出生体重≥1500 g早产儿的脑损伤发生率19.62%(271/1381)明显低于出生体重<1500 g早产儿的29.08%(57/196),差异有统计学意义(P<0.05)。结论 出生胎龄越小、出生体质量越低,早产儿脑损伤及重度脑损伤的发生率则越高。

Objective To explore the correlation of brain injury in premature infants(BIPI)with gestational age and birth weight based on the results of cranial ultrasound(CUS)in premature infants.Methods The clinical data of 1577 premature infants were retrospectively analyzed,and all premature infants underwent cranial ultrasound,and the results of cranial ultrasound were analyzed to compare the incidence of brain injury in premature infants of different gestational ages and birth weights.Results Cranial ultrasound detected brain injury in 328 of 1577 premature infants,including 226 cases of periventricular-intraventricular hemorrhage(PIVH),79 cases of periventricular leukomalacia(PVL),and 23 cases of PIVH with PVL;84 cases of other mild abnormalities;and 1,165 normal cases.The incidence rates of brain injury in premature infants with gestational age≤30,31-32,33-34,and 35-36 weeks were 39.06%(50/128),25.13%(48/191),19.88%(101/508),and 17.20%(129/750),respectively,with the increase in the gestational age of premature infants,the incidence of brain injury gradually decreased.The incidence of brain injury in premature infants of different gestational ages was statistically significant(P<0.05).There was no statistically significant difference in the incidence of brain injury in premature infants of different gestational ages(P>0.05).There was no statistically significant difference in the incidence of mild brain injury in premature infants of different gestational ages(P>0.05).The incidence rate of severe brain injury of premature infants with gestational age≤32 weeks was 2.51%(8/319),which was significantly higher than that of 0.08%(1/1258)of premature infants with gestational age>32 weeks,and the difference was statistically significant(P<0.05).The incidence of brain injury in premature infants with birth weight≥1500 g was 19.62%(271/1381),which was lower than that of 29.08%(57/196)in premature infants with birth weight<1500 g,and the difference was statistically significant(P<0.05).Conclusion The smaller the gestational age at birth and the lower the birth weight,the higher the incidence of brain injury and severe brain injury in premature infants.