早产儿脑损伤相关危险因素的研究

Influencing Factors of Brain Injury in Premature Infants

摘要: 目的：探讨早产儿脑损伤发生的相关危险因素，为降低早产儿脑损伤的发生率及改善远期预后提供临床参考依据。方法：选取2019年8月~2020年8月在我院新生儿重症监护室治疗的55例脑损伤早产儿为观察组；另外选取同时期住院的70例非脑损伤的早产儿为对照组。比较两组母亲因素及早产儿情况，并采用多因素Logistic回归分析早产儿脑损伤发生的危险因素。结果：脑损伤组与无脑损伤组早产儿组孕母因素相比，除产前应用激素和母孕期感染外，分娩方式、羊水异常、胎膜早破、孕母贫血、胎盘异常、脐带异常、妊娠期糖尿病、妊娠期高血压等方面差异均无统计学意义(P < 0.05)。在早产儿组基本情况上，除生后低血糖、胎儿宫内窘迫、呼吸暂停外，新生儿脓毒症、新生儿贫血、动脉导管未闭、机械通气、生后1分钟Apgar评分、新生儿呼吸窘迫综合征和高碳酸血症差别均有统计学意义(P < 0.05)。对早产儿脑损伤的多因素Logistic回归分析，显示新生儿呼吸窘迫综合征、机械通气、母孕期感染、新生儿脓毒症和生后1分钟Apgar评分为脑损伤的独立危险因素，差别均有统计学意义(P < 0.05)。结论：早产儿脑损伤是多种因素相互作用的复杂结果，发生的相关危险因素包括孕母因素及新生儿因素。

Abstract: Objective: To analyze the influencing factors for brain injury in premature infants. Methods: Selected 55 premature infants with brain injury were treated in intensive-care unit from 2019.08 to 2020.08 as the observation group. In addition, 70 premature infants without brain injury who were hospitalized at the same time were selected as the control group. Maternal factors and preterm birth were compared between the two groups. The risk factors of brain injury in preterm infants were analyzed by multiple Logistic regression. Results: The maternal factors of preterm infants in brain injury group were compared with those in non-brain injury group in addition to prenatal use of hormones and maternal infection. There were no significant differences in delivery mode, amniotic fluid abnormality, premature rupture of membranes, maternal anemia, placenta abnormality, umbilical cord abnormality, gestational diabetes mellitus and gestational hypertension (P < 0.05). In the preterm group, except post-natal hypoglycemia, fetal distress and apnea, Neonatal Sepsis, neonatal anemia, Patent Ductus Arteriosus, mechanical ventilation, Apgar score at 1 minute after birth, Infant respiratory distress syndrome and hypercapnia were significantly different (P < 0.05). Multiple Logistic Regression analysis of brain injury in preterm infants, Infant Respiratory Distress Syndrome, mechanical ventilation, maternal infection, neonatal sepsis, and Apgar Score 1 minute after birth were independent risk factors for brain injury. The differences were statistically significant (P < 0.05). Conclusion: Brain injury in premature infants is a complex result of the interaction of many factors. The related risk factors include pregnant mother factor and newborn factor.