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与脑室内出血及脑室周围白质软化症发生相关的危险因素。

Risk factors associated with the development of peri-intraventricular haemorrhage and periventricular leukomalacia.

作者信息

Tzogalis D, Fawer C L, Wong Y, Calame A

机构信息

Department of Paediatrics, University of Lausanne, Switzerland.

出版信息

Helv Paediatr Acta. 1989 Jun;43(5-6):363-76.

PMID:2745134
Abstract

81 preterm infants of 34 weeks' gestation or less were prospectively and sequentially examined by means of real-time ultrasound in order to identify which clinical risk factors might be associated with the development of peri-intraventricular haemorrhage (PVH) and periventricular leukomalacia (PVL). Infants were allocated in three groups: group A (n = 44): with normal scans; group B (n = 24): with isolated PVH, and group C (n = 13): with PVL. 28 obstetrical and neonatal factors were compared within the three groups using two methods of statistical analysis (2 x 2 chi 2 analysis and multivariate logistic regression analysis). Hyaline membrane disease, acidosis, pneumothorax and Apgar score at 10 min were statistically associated with PVH. The multivariate logistic regression analysis showed that need for resuscitation, hyaline membrane disease, acidosis and gestational age were the most important factors. Gestational age, seizures, hyaline membrane disease, apnoea with hypoxaemia and bradycardia were strongly associated with PVL. These results suggest that a low gestational age, the need for resuscitation and a respiratory distress syndrome with its consequences might lead to PVH, whereas a low gestational age, hypoxaemia and cardiocirculatory disturbances might decrease cerebral perfusion and result into PVL.

摘要

对81名妊娠34周及以下的早产儿进行了实时超声前瞻性连续检查,以确定哪些临床风险因素可能与脑室内出血(PVH)和脑室周围白质软化(PVL)的发生有关。婴儿被分为三组:A组(n = 44):扫描正常;B组(n = 24):孤立性PVH;C组(n = 13):PVL。使用两种统计分析方法(2×2卡方分析和多因素逻辑回归分析)对三组中的28个产科和新生儿因素进行了比较。透明膜病、酸中毒、气胸和10分钟时的阿氏评分与PVH有统计学关联。多因素逻辑回归分析表明,复苏需求、透明膜病、酸中毒和胎龄是最重要的因素。胎龄、惊厥、透明膜病、低氧血症性呼吸暂停和心动过缓与PVL密切相关。这些结果表明,低胎龄、复苏需求以及呼吸窘迫综合征及其后果可能导致PVH,而低胎龄、低氧血症和心血管循环障碍可能会减少脑灌注并导致PVL。

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