早产儿脑损伤危险因素回顾性分析

发布时间：2018-11-17 13:03

【摘要】：目的:通过研究早产儿脑损伤的高危因素,避免高危因素的发生,从而降低早产儿脑损伤的发病率,改善早产儿的预后,提高其生活质量。方法:研究近3年来新生儿科住院早产儿的头颅磁共振成像检查,根据头颅MRI结果将有异常表现的设为早产儿脑损伤组,无异常为对照组。其中脑损伤组又分为单纯缺氧缺血性损伤组,单纯出血性损伤组,以及两者混合性损伤组。详细统计临床资料,通过对相关因素分析,行Logistic回归分析统计学方法,筛选出与早产儿脑损伤有关的危险因素,以及不同脑损伤组的危险因素。结果:1.纳入调查范围内的早产儿共229例,其中诊断为早产儿脑损伤85例;对照组144例。早产儿脑损伤组中单纯缺氧缺血性损伤21例,单纯出血性损伤52例,两者混合性损伤12例。2.通过Logistic回归分析提示:(1)胎龄、胎膜早破、分娩方式、BE、机械通气、新生儿感染与早产儿脑损伤的发生有关,有统计学意义(p0.05);其中小胎龄、低BE值为危险因素。(2)单纯缺氧缺血性损伤组:低BE值、新生儿感染为危险因素;单纯出血性损伤组:新生儿感染、胎膜早破、机械通气为危险因素;混合性脑损伤组:机械通气为危险因素。结论:1.早产儿脑损伤是多种因素相互作用的结果,其发病基础是早产儿发育的不成熟和易感性。2.小胎龄、胎膜早破、低BE值、机械通气、新生儿感染是早产儿脑损伤的危险因素。
[Abstract]:Objective: to study the high risk factors of brain injury in premature infants, to avoid the occurrence of high risk factors, to reduce the incidence of brain injury in preterm infants, to improve the prognosis of premature infants and to improve their quality of life. Methods: the cranial magnetic resonance imaging of premature infants in recent 3 years was studied. According to the results of cranial MRI, the abnormal findings were divided into premature infants with brain injury group and no abnormal group as control group. The brain injury group was divided into simple hypoxic-ischemic injury group, hemorrhagic injury group, and mixed injury group. The clinical data were analyzed in detail and the risk factors related to brain injury of premature infants and different brain injury groups were screened by Logistic regression analysis. The result is 1: 1. A total of 229 premature infants were included in the study, including 85 cases of brain injury diagnosed as premature infants and 144 cases of control group. There were 21 cases of pure hypoxic-ischemic injury, 52 cases of hemorrhagic injury and 12 cases of mixed injury. Logistic regression analysis showed that: (1) gestational age, premature rupture of membranes, mode of delivery, BE, mechanical ventilation and neonatal infection were associated with brain injury in premature infants (p0.05); Among them, small gestational age, low BE value is the risk factor. (2) simple hypoxic-ischemic injury group: low BE value, neonatal infection as a risk factor, hemorrhagic injury group: neonatal infection, premature rupture of fetal membranes, mechanical ventilation as a risk factor; Mixed brain injury group: mechanical ventilation was the risk factor. Conclusion: 1. Brain injury in premature infants is the result of the interaction of many factors, and its pathogenesis is based on premature infants' immature development and susceptibility. 2. Small gestational age, premature rupture of membranes, low BE, mechanical ventilation and neonatal infection were risk factors of brain injury in premature infants.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R722.6

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