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目的探讨早产儿脑损伤的发生率及影响因素,为临床防治提供参考依据。方法采用颅脑超声,对260例早产儿进行脑损伤筛查,了解早产儿脑损伤发生率,并分析增加脑损伤发生率和加重脑损伤程度的高危因素。结果共检出脑损伤174例(66.9%),其中PIVH 138例(53.1%),重度PIVH 25例,重度PIVH发生率9.6%;PVL 39例,发生率15%。分析显示:胎龄小、围产期缺氧、酸中毒、高浓度吸氧、机械通气等均增加颅内出血的发生率,胎龄、围产期缺氧史、酸中毒可影响颅内出血的程度;胎龄、体重越小,胎膜早破、感染、围产期缺氧、酸中毒、机械通气、低碳酸血症、颅内出血均增加白质软化的发生率;产前应用DXM可降低脑损伤的发生率。结论加强围生期保健,预防早产,避免围产期缺氧、出生后并发症是减少脑损伤发生的重要环节。
Objective To investigate the incidence and influencing factors of brain injury in premature infants and provide reference for clinical prevention and treatment. Methods 260 cases of premature infants were screened for brain injury using cranial ultrasound to understand the incidence of brain injury in premature infants and to analyze the risk factors for increasing the incidence of brain injury and increasing the degree of brain injury. Results A total of 174 cases (66.9%) of brain injury were detected. PIVH was found in 138 cases (53.1%), severe PIVH in 25 cases, severe PIVH in 9.6% and PVL in 39 cases (15%). Analysis showed that: gestational age, perinatal hypoxia, acidosis, high concentrations of oxygen, mechanical ventilation and so increase the incidence of intracranial hemorrhage, gestational age, perinatal hypoxia, acidosis can affect the degree of intracranial hemorrhage ; Gestational age, body weight smaller, premature rupture of membranes, infection, perinatal hypoxia, acidosis, mechanical ventilation, hypocapnia, intracranial hemorrhage increased the incidence of white matter softening; prenatal DXM can reduce brain damage The incidence of. Conclusions Strengthening perinatal care, preventing premature birth, avoiding perinatal hypoxia and postnatal complications are important links to reduce brain injury.