早产儿颅内出血发生率及其影响因素研究

摘要

Objective To study the incidence of intracranial hemorrhage in premature infants,and analyze the risk factors.Mothods 931 hospitalized premature infants that collected from the Department of Neonatology in Dongguan Matemal and Child Health Care Hospital from Jan.2009 to Nov.2010were checked with cranial uhrasonography within the first 3 days,and were reexamined by the time 1 week,2 weeks and 1 month after birth.Data regarding maternal factors,delivery characteristics,fetal risk factors,antenatal steroid administration,maternal magnesium sulfate therapy,gestational age,birth weight and neonatal parameters were collected.Results Among the 931 premature infants,485 cases(52.1%)had ICH;71 cases(7.6%)had severe ICH(including cerebral parenchymal hemorrhage 2 cases).It was confirmed that gestational age,birth weight,mode of delivery,asphyxia,mechanical ventilation,surfactant therapy,and low blood pH were risk factors of intracranial hemorrhage in premature infants.Conclusion It is useful to examine premature infant with color ultrasound on skull in early life;it helps to diagnose ICH early;and it's useful to improve the prognosis of premature infants.%目的 研究早产儿颅内出血的发病率,分析其影响因素.方法 对2009年1月-2010年11月在东莞市妇幼保健院新生儿科住院的931例早产儿于出生3天内行头颅超声检查,并酌情于生后1周、2周、1个月时复查.同时收集相关床资料(产妇因素,产程中因素,胎儿因素,产前激素、硫酸镁应用,婴胎龄、出生体重,生后因素).结果 早产儿颅脑出血发生率:931例早产儿中485例发生不同程度颅脑出血,颅脑出血总发生率为52.1%;重度出血71例(包含2例脑实质出血),发生率为7.6%.生后3天内颅内出血占总发生率92.1%,生后1周时96.1%,说明颅内出血绝大多数发生在生后1周内.证实胎龄、出生体重、生产方式、出生时窒息、常规呼吸机治疗、肺泡表面活性物质(PS)治疗、动脉血气分析pH值低等为早产儿颅内出血的高危因素.结论 早产儿生后早期行颅脑超声检查对提高早产儿成活率及改善早产儿预后有重要意义.