中国全科医学2017，Vol.20Issue(4)：459-464,6.DOI:10.3969/j.issn.1007-9572.2017.04.016
早产儿脑损伤的影响因素研究
Influencing Factors of Brain Injury in Premature Infants
摘要
Abstract
Objective To analyze the influencing factors for brain injury in premature infants (BIPI).Methods The subjects enrolled in this study were 151 premature infants who were born in Zhangzhou Affiliated Hospital of Fujian Medical University from June 2014 to December 2015 and admitted to the Neonatal Intensive Care Unit (NICU) immediately after birth.B -ultrasound and magnetic resonance imaging (MRI) were used to detect the incidence of BIPI,including hemorrhagic brain injury and ischemic brain injury.We collected the clinical data of the premature infants by consulting their medical records.The factors affecting the incidences of hemorrhagic brain injury and ischemic brain injury in premature infants were analyzed with a multivariate Logistic regression model.Results Of the 151 premature infants,61 (40.4％) had brain injuries,including 47 (31.1％) with hemorrhagic brain injury and 33 (21.8％) with ischemic brain injury,and 19 (12.6％) with hemorrhagic and ischemic brain injury.Results of single factor analysis showed that gestational age,puerperants with histological chorioamnionitis (HCA),neonatal sepsis,hypoxia and asphyxia,metabolic acidosis,mechanical ventilation were significantly associated with hemorrhagic brain injury (P ＜ 0.05).Neonatal sex,mode of delivery,birth weight,polyembryony,maternal gestational diabetes mellitus (GDM),gestational hypertension,infection during pregnancy,maternal dexamethasone treatment,neonatal hypoglycemia,hypercapnia,hypocapnia,and pulmonary complications were not strongly correlated with hemorrhagic brain injury (P ＞ 0.05).Puerperants with HCA,neonatal sepsis,hypoxic and asphyxia,mechanical ventilation were remarkably associated with ischemic brain injury (P ＜ 0.05).Neonatal sex,gestational age,mode of delivery,birth weight,polyembryony,maternal GDM,gestational hypertension,infection during pregnancy,maternal dexamethasone treatment,neonatal hypoglycemia,metabolic acidosis,hypercapnia,hypocapnia,and pulmonary complications were not significantly correlated with ischemic brain injury (P ＞ 0.05).Results of the multivariate Logistic regression analysis revealed that gestational age,puerperants with HCA,neonatal sepsis,hypoxia and asphyxia,metabolic acidosis were influencing factors for hemorrhagic brain injury (P ＜0.05);puerperants with HCA,neonatal sepsis,hypoxia and asphyxia were influencing factors for ischemic brain injury (P ＜ 0.05).Conclusion The incidence of brain injury is high in premature infants.Gestational age under 32 weeks,puerperants with HCA,neonatal sepsis,hypoxic,asphyxia and metabolic acidosis are the risk factors for BIPI.关键词
婴儿,早产/脑损伤/影响因素分析Key words
Infant, premature/Brain injuries/Root cause analysis分类
医药卫生引用本文复制引用
方小红,许丽萍,林丽聪,陈雯雯,张浩,黄小玲..早产儿脑损伤的影响因素研究[J].中国全科医学,2017,20(4):459-464,6.基金项目
福建省卫生厅青年科研课题立项(2012-3-113) （2012-3-113）
