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目的调查新疆医科大学第一临床学院住院早产儿脑损伤发生率及影响因素。方法对2003-08—2005-10新生儿科收治的404例早产儿应用ABR4000S/LB超诊断仪在生后3~7d内常规进行床边头颅B超检查。结果150例早产儿存在脑损伤,平均胎龄为(33·27±1·99)周;平均出生体重(1992·9±505·2)g。总的脑室内出血(IVH)发生率为35·1%(142/404),脑室周围白质软化(PVL)的发生率为3·5%(14/404),轻度和重度脑损伤发生率分别为23·5%(95/404)、13·6%(55/404)。胎龄越小,体重越低,脑损伤发生率越高,但与颅内出血程度无关。窒息程度与脑损伤程度密切相关。并发症肺透明膜病、呼吸暂停、呼吸衰竭、肺出血、低血糖、多器官功能损害及贫血与脑损伤程度有关。母妊高征、胆汁淤积、胎膜早破、胎龄小、出生体重低及HFOV治疗可使早产儿脑损伤发生率增高。结论早产儿脑损伤的发生及严重程度与多因素有关,头颅B超可对早产儿脑损伤作出早期诊断,为早期干预提供依据。
Objective To investigate the incidence and influencing factors of brain injury in hospitalized premature infants in the First Clinical College of Xinjiang Medical University. Methods A total of 404 preterm infants admitted to Department of Neonatology from August 2003 to August 2005 were examined by bedside cranial ultrasound B with ABR4000S / LB ultrasonography instrument within 3 ~ 7 days after birth. Results 150 premature infants had brain injury with an average gestational age of (33.27 ± 1.99) weeks and a mean birth weight (1992.9 ± 505.2) g. The incidence of total intracerebral hemorrhage (IVH) was 35.1% (142/404), and the incidence of periventricular leukomalacia (PVL) was 3.5% (14/404). The incidence of mild and severe brain injury were 23.5% (95/404), 13.6% (55/404). The smaller the gestational age, the lower the body weight, the higher the incidence of brain injury, but not with the degree of intracranial hemorrhage. Degree of asphyxia and brain injury are closely related. Complications Hyaline membrane disease, apnea, respiratory failure, pulmonary hemorrhage, hypoglycemia, multiple organ dysfunction and anemia are related to the degree of brain injury. Pregnancy-induced hypertension, cholestasis, premature rupture of membranes, small gestational age, low birth weight, and treatment with HFOV can increase the incidence of brain injury in preterm infants. Conclusions The incidence and severity of brain injury in preterm infants are related to many factors. Early diagnosis of brain injury in preterm infants may be made by B-ultrasound in the head, providing a basis for early intervention.