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【目的】探讨高危住院早产儿颅内出血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320例高危早产儿进行了颅内出血筛查,对颅内出血的可能影响因素分别进行了单因素和多因素Logistic回归分析。【结果】①共检出颅内出血56例(17.50%),其中脑室周围-脑室内出血(periventricular-intraven-tricular hemorrhage PIVH)50例(15.63%),PIVH中66%为Ⅰ度出血,20%为Ⅲ~Ⅳ度严重出血;②单因素回归分析显示:胎龄、窒息和/或宫内窘迫、机械通气治疗、高浓度氧疗、代谢性酸中毒是颅内出血的高风险因素,而母产前应用糖皮质激素可以减少颅内出血的发生。将上述因素进行逐步Logistic回归分析后发现胎龄、窒息和/或宫内窘迫对高危早产儿颅内出血的发生有重要的作用。【结论】加强围生期保健,预防早产,避免宫内缺氧和窒息是减少颅内出血发生的重要环节。
【Objective】 To investigate the incidence and influencing factors of intracranial hemorrhage in high-risk hospitalized premature infants and provide reference for clinical prevention and treatment. 【Methods】 Intracranial hemorrhage screening was performed in 320 high risk preterm infants with intracranial ultrasound. Univariate and multivariate logistic regression analyzes were performed on the possible influencing factors of intracranial hemorrhage. 【Results】 ①A total of 56 cases (17.50%) of intracranial hemorrhage were detected, including 50 cases (15.63%) of periventricular-intravenous-tricular hemorrhage (PIVH), 66% of PIVH, and 20% Ⅲ ~ Ⅳ degree of severe bleeding; ② univariate regression analysis showed that: gestational age, asphyxia and / or intrauterine distress, mechanical ventilation therapy, high concentration of oxygen therapy, metabolic acidosis is a high risk of intracranial hemorrhage, Glucocorticoid can reduce the incidence of intracranial hemorrhage. Logistic regression analysis of the above factors found that gestational age, asphyxia and / or intrauterine distress play an important role in the occurrence of intracranial hemorrhage in high-risk premature infants. 【Conclusion】 Strengthening perinatal care, preventing premature delivery, avoiding intrauterine hypoxia and asphyxia are important links to reduce intracranial hemorrhage.