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背景:脑室周围-脑室内出血是早产儿死亡和伤残的重要原因,大样本调查资料可为早产儿脑室周围-脑室内出血发生率及其高危因素的分析提供支持性数据。目的:认识早产儿脑室周围-脑室内出血的发生率及其高危因素。设计:调查分析。单位:华中科技大学同济医学院同济医院,首都医科大学附属北京妇产医院,河北省秦皇岛市妇幼保健院。对象:选择2002-01/2005-08在北京妇产医院和秦皇岛市妇幼保健院出生,并于生后1周内作头颅超声检查的早产儿1122例,男594例,女528例,胎龄26.3～36.8周,出生时体质量(850～4500)g。方法:1122例早产儿于生后1周内常规作头颅超声检查,并记录相关围产因素。使用仪器为NewPhilips5500型和GEHealthcareLogiq400型超声诊断仪(分别由荷兰Philip公司和美国GE公司生产)。主要观察指标:脑室周围-脑室内出血相关因素分析结果。结果:纳入早产儿1122例全部进入结果分析。其中619例发生了不同程度的脑室周围-脑室内出血(55.2%);重度出血占出血总数的17.8%。小胎龄、低体质量、机械通气、低血糖、高碳酸血症、高乳酸血症、酸中毒、缺氧、血液凝固机制异常等为早产儿颅内出血的主要高危因素,产前使用地塞米松可降低小胎龄早产儿颅内出血发生率。结论:早产儿出生后常规作头颅超声检查,早期发现并定期随访对减少神经系统后遗症有重要意义。
BACKGROUND: Periventricular - intraventricular hemorrhage is an important cause of death and disability in preterm infants. Large sample data provide supportive data on the incidence of periventricular - intraventricular hemorrhage and its risk factors in preterm infants. Objective: To understand the incidence of periventricular - intraventricular hemorrhage and its risk factors in preterm infants. Design: Survey Analysis. Unit: Tongji Hospital, Huazhong University of Science and Technology Tongji Hospital, Capital Medical University Affiliated Beijing Maternity Hospital, Qinhuangdao City, Hebei Province Maternal and Child Health Hospital. PARTICIPANTS: A total of 1122 preterm infants born at Beijing Maternity Hospital and Maternal and Child Health Hospital of Qinhuangdao City from January 2002 to August 2005 were screened for head ultrasound within 1 week after birth. There were 594 males and 528 females, 26.3 ~ 36.8 weeks, body mass at birth (850 ~ 4500) g. Methods: 1122 preterm infants were routinely screened for head ultrasound within 1 week after birth and the related perinatal factors were recorded. The instruments used were the New Philips H5500 and GE Healthcare Parach400 models (manufactured by Philip, Netherlands and GE, USA, respectively). MAIN OUTCOME MEASURES: Results of analysis of related factors around periventricular - intraventricular hemorrhage. Results: 1122 preterm infants were included in the result analysis. Among them, 619 cases had different degrees of periventricular - intraventricular hemorrhage (55.2%); severe bleeding accounted for 17.8% of the total number of bleeding. Small gestational age, low body weight, mechanical ventilation, hypoglycemia, hypercapnia, hyperlipidemia, acidosis, hypoxia, abnormalities in blood coagulation mechanisms are the main risk factors for intracranial hemorrhage in preterm infants. Meson can reduce the incidence of intracranial hemorrhage in preterm infants of small gestational age. CONCLUSIONS: Premature babies are routinely screened for ultrasound after birth. Early detection and regular follow-up are important for reducing neurological sequelae.