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目的 了解围产因素与极低出生体重儿 (VL BW)脑室周围 -脑室内出血的相关性 ,从而产生预见性价值。 方法 对 4 12例住院的 VL BW定期头颅 B超检查 ,对合并出血进行分级。应用逐步 L ogistic回归分析法寻找脑室周围 -脑室内出血和重度脑室内出血的预测因素。 结果 4 12例VL BW脑室周围 -脑室内出血发生率为 2 5 .0 % (10 3/ 4 12 ) ,病死率为 39.8% (41/ 10 3)。合理干预后 ,其发生率从 1994年的 32 .0 %逐渐下降 ,2 0 0 0年为 17.6 %。胎龄小、体重低发生率较高。通过对相关因素多变量分析得出导致脑室周围 -脑室内出血独立预测因素分别为围产期窒息 (5 min Apgar评分 <5分 ) :比值比 (OR)为 2 .4 6 ,95 %可信区间为 1.4 8,4 .4 2 ;胎龄小于 2 9周 :OR为 2 .37,95 % ,可信区间为1.35、3.6 8;重度呼吸窘迫综合征 :OR为 2 .16 ,95 %可信区间为 1.34、4 .19;阴道分娩 :OR为 2 .14 ,95 %可信区间为 1.2 5、3.6 8。导致重度脑室内出血的独立预测因素是气胸 :OR为 2 .70 ,95 %可信区间为 1.12、6 .5 7;平均出生体重小于 95 6 g:OR为 4 .0 2 ,95 %可信区间为 1.15、4 .12。 结论 采取合理干预措施有利于避免脑室周围 -脑室内出血的发生和发展
Objective To understand the relationship between perinatal factors and periventricular-intraventricular hemorrhage in VLWL, and to generate predictive value. Methods A total of 41 12 hospitalized VL BW skull ultrasound examinations were performed to classify the combined bleeding. Use stepwise logistic regression analysis to find the predictive factors of periventricular - intraventricular hemorrhage and severe intraventricular hemorrhage. Results The incidence of periventricular / intraventricular hemorrhage in 12 12 VL patients was 25.0% (10 3/4 12) and the case fatality rate was 39.8% (41/103). After reasonable intervention, its incidence gradually decreased from 32.0% in 1994 to 17.6% in 2000. Small gestational age, high prevalence of low body weight. By multivariate analysis of relevant factors, the independent predictors of periventricular-ventricular hemorrhage were as follows: perinatal asphyxia (5 min Apgar score <5): odds ratio (OR) was 2.46, 95% confidence interval OR was 2.37, 95%, confidence interval was 1.35, 3.6 8; severe respiratory distress syndrome: OR was 2.16, 95% confidence The interval was 1.34, 4.19; vaginal delivery: OR was 2.14, the 95% confidence interval was 1.2 5, 3.6 8. The independent predictors of severe intraventricular hemorrhage were pneumothorax: OR 2.70, 95% confidence interval 1.12, 6. 57; mean birth weight 956 g OR: 4.02, 95% confidence interval Is 1.15,4.12. Conclusion Reasonable interventions are helpful to avoid the occurrence and development of periventricular-intraventricular hemorrhage