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[早产儿脑损伤的影响因素]

[Influencing factors for brain injury in preterm infants].

作者信息

Ma Li, Wen Xiao-Hong, Yang Hai-Bo, Huang Jin-Hua, Chen Nan

机构信息

Department of Pediatrics, Third Affiliated Hospital of Anhui Medical University, Hefei 230061, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2016 Jun;18(6):471-5. doi: 10.7499/j.issn.1008-8830.2016.06.001.

Abstract

OBJECTIVE

To investigate the incidence of different types of brain injury in preterm infants and their influencing factors.

METHODS

The clinical data and head magnetic resonance imaging (MRI) findings of 239 preterm infants were collected, and the influence of antepartum, intrapartum, and postpartum factors on brain injury in preterm infants was analyzed.

RESULTS

The incidence rate of brain injury in preterm infants was 25.5%; among these infants, 10.5% had hemorrhagic brain injury, 10.5% had ischemic brain injury, and 4.6% and hemorrhagic and ischemic brain injury. The infants with a lower gestational age had higher incidence rates of hemorrhagic brain injury and overall brain injury (P<0.01). The incidence rates of ischemic brain injury and hemorrhagic and ischemic brain injury were not correlated with gestational age (P>0.05). The incidence rates of hemorrhagic, ischemic, and overall brain injury were not correlated with birth weight (P>0.05). Multiparity (OR=0.292, 95%CI 0.088-0.972) and cesarean section (OR=0.075, 95%CI 0.015-0.368) were protective factors against brain injury in infants with a gestational age of <34 weeks; cesarean section (OR=0.296, 95%CI 0.131-0.672) was the protective factor against brain injury in infants with a gestational age of ≤34 weeks, and severe infection (OR=8.176, 95%CI 1.202-55.617) was the risk factor.

CONCLUSIONS

In order to prevent or reduce the occurrence of brain injury in preterm infants. the gestational age of preterm infants should be prolonged as much as possible and the indications for cesarean section should be grasped. Infections should be prevented and if occurring should be treated actively and effectively.

摘要

目的

探讨早产儿不同类型脑损伤的发生率及其影响因素。

方法

收集239例早产儿的临床资料及头部磁共振成像(MRI)结果,分析产前、产时及产后因素对早产儿脑损伤的影响。

结果

早产儿脑损伤发生率为25.5%;其中,10.5%发生出血性脑损伤,10.5%发生缺血性脑损伤,4.6%发生出血性和缺血性脑损伤。孕周较小的婴儿出血性脑损伤和总体脑损伤的发生率较高(P<0.01)。缺血性脑损伤以及出血性和缺血性脑损伤的发生率与孕周无关(P>0.05)。出血性、缺血性和总体脑损伤的发生率与出生体重无关(P>0.05)。多胎妊娠(OR=0.292,95%CI 0.088-0.972)和剖宫产(OR=0.075,95%CI 0.015-0.368)是孕周<34周婴儿脑损伤的保护因素;剖宫产(OR=0.296,95%CI 0.131-0.672)是孕周≤34周婴儿脑损伤的保护因素,而严重感染(OR=8.176,95%CI 1.202-55.617)是危险因素。

结论

为预防或减少早产儿脑损伤的发生,应尽可能延长早产儿孕周,把握剖宫产指征,预防感染,一旦发生应积极有效治疗。

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