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目的探讨极低出生体重儿脑室周围-脑室内出血(PVH-IVH)的相关因素。方法回顾性分析2006—2009年本院新生儿科收治的极低出生体重儿,根据是否发生PVH-IVH分为病例组和对照组,比较两组患儿的产前、产时及产后情况,对有意义的因素进行多因素Logistic回归分析。结果共收治极低出生体重儿131例,入选122例,其中病例组60例,对照组62例。病例组胎龄、体重、生后第1天pH值及母亲产前应用糖皮质激素的比例均低于对照组[胎龄(30.9±2.6)周比(31.8±2.3)周,体重(1252±153)g比(1310±140)g,pH值(7.28±0.09)比(7.35±0.08),产前激素16.7%比32.3%,P均<0.05],窒息、机械通气、低血糖的比例均高于对照组(窒息81.7%比46.8%,机械通气28.3%比12.9%,低血糖50.0%比30.6%,P均<0.05)。多因素分析显示,产前应用糖皮质激素、胎龄、体重、窒息和生后第1天pH值是极低出生体重儿发生PVH-IVH的相关因素。结论产前应用糖皮质激素、胎龄、体重、窒息和生后第1天pH值是极低出生体重儿发生PVH-IVH的相关因素,产前应用糖皮质激素可以降低PVH-IVH的发生率。
Objective To investigate the related factors of periventricular-intraventricular hemorrhage (PVH-IVH) in very low birth weight infants. Methods A retrospective analysis of neonates with very low birth weight admitted to our hospital from 2006 to 2009 was conducted. The incidence of prenatal, postnatal and postnatal periods was compared between the two groups according to whether PVH-IVH occurred or not. Multivariate logistic regression analysis of significant factors. Results A total of 131 cases with very low birth weight were enrolled in this study. Of the 122 cases, there were 60 cases in the case group and 62 cases in the control group. The cases of gestational age, body weight, pH and the proportion of maternal prenatal glucocorticoid were lower than that of the control group [gestational age (30.9 ± 2.6) weeks vs (31.8 ± 2.3 weeks, body weight (1252 ± 153) g (1310 ± 140) g, pH (7.28 ± 0.09), (7.35 ± 0.08), prenatal hormone 16.7% vs 32.3%, P <0.05, asphyxia, mechanical ventilation and hypoglycemia (81.7% vs. 46.8% for asphyxia, 28.3% vs. 12.9% for mechanical ventilation, 50.0% vs. 30.6% for hypoglycemia, P <0.05). Multivariate analysis showed that prenatal glucocorticoid administration, gestational age, weight, asphyxia and pH value on the first day after birth were the related factors of PVH-IVH in very low birth weight infants. Conclusions Prenatal glucocorticoid, gestational age, body weight, asphyxia and pH value on the first day of life are the related factors of PVH-IVH in very low birth weight infants. Prenatal glucocorticoid can reduce the incidence of PVH-IVH .