标题：早产儿脑损伤的发生及其高危因素分析

      作者：汪 皓 1，杨 勇 1，陈秋梅 2，王 维 2
    (1.深圳市妇幼保健院儿科，广东 深圳 518028；
2.深圳市宝安区妇幼保健院妇产科，广东 深圳 518133)

      卷次： 2013年24卷13期

      【摘要】 目的 了解早产儿脑损伤的发生情况，探讨其发生的高危因素。方法 回顾性分析我院2009年1
月至 2012年 12月收治的 3 788例早产儿中发生脑损伤的情况，采用多因素Logistic回归模型分析其高危因素。
结果 3 788例早产儿中脑损伤的发生率为19.38%；脑室内出血(IVH)和脑室周围白质软化(PVL)的发生率分别
为16.42%和2.96%，其中轻度脑损伤发生率为13.75%，重度脑损伤的发生率为5.62%。IVH的独立危险因素有坏死
性小肠结肠炎(NEC)、机械通气(MV)、动脉导管未闭(PDA)，保护性因素有胎龄和出生5 min的Apgar评分，PVL的危
险因素有 IVH、MV、母亲分娩前或分娩时感染。IVH更容易导致早产儿死亡。结论 早产儿的胎龄越小，出生体重
越低，IVH的发生率越高。NEC、MV、PDA、IVH、围生期感染、窒息缺氧等与早产儿脑损伤的发生密切相关。

      【关键词】 早产儿；脑损伤；发生率；高危因素

      【中图分类号】 R722 【文献标识码】 A 【文章编号】 1003—6350（2013）13—1932—03


Incidence and risk factor analysis of brain injury in preterm infant.
WANG Hao 1, YANG Yong 1, CHEN Qiu-mei 2,
WANG Wei 2. 1. Shenzhen Maternity and Child Care Centers, Shenzhen 518028, Guangdong, CHINA; 2. Maternal and
Child Health Hospital of Bao'an District of Shenzhen, Shenzhen 518133, Guangdong, CHINA

【Abstract】 Objective To explore the incidence and risk factors of brain injury in preterm infants.
Methods The Logistic regression model was employed to analyze the high risk factors of preterm infants with brain
injury. Results The incidence of brain injury in the preterm infants was 19.38%, and that of intraventricular haemor-
rhage (IVH) and periventrieular leukomalacia (PVL) were 16.42% and 2.96%, respectively. The mild brain injury rate
was 13.75%, and the severe one was 5.62%. The independent risk factors for IVH included neonatal necrotizing en-
terocolitis (NEC), mechanicalventilation (MV), patentductus arteriosus (PDA), while larger gestational age and high-
er 5 min Apgar scores were protective factors. IVH, MV and maternal perinatal infection were risk factors in PVL.
Conclusion The incidence of brain injury is negatively related to gestational age and birth weight. NEC, MV, PDA,
IVH, maternal perinatal infection and hypoxia are all associated with increased risk of brain injury in premature infants.

      【Key words】 Preterm infant; Brain injury; Incidence; Risk factor