早产儿脑室内出血高危因素的探讨

目的 采用床旁头部B超研究早产儿脑室内出血(IVH)发病情况,并对相关实验室检查结果 进行分析,以探讨IVH的高危因素.方法 2003年2月至2004年3月我院儿科病房共收治114例早产儿,应用东软NAS-2000型三维彩超诊断仪对早产儿在生后3 d进行床边头部B超检查,探查IVH发病情况;在生后24 h内进行血气分析、血细胞分析、凝血三项测定.结果 114例早产儿中,IVH34例,占29.8%.胎龄28～34周早产儿IVH发病率(43.8%)高于35周以上早产儿(12.0%),1500 g以下早产儿IVH发病率(58.8%)高于1500 g以上早产儿(24.7%),差异均有非常显著性(P＜0.01).与非IVH患儿比较,IVH患儿血红蛋白、血细胞比容明显增高(P＜0.05);凝血酶原时间、部分凝血活酶时间延长(P＜0.01);低氧血症、高碳酸血症、酸中毒发病率增加(P＜0.05).结论 小胎龄、低体重、贫血、血细胞比容增高、血小板计数下降、凝血异常、低氧血症及酸中毒可能与IVH发生有关.

Clinical study on high risk factors for intraventricular hemorrhage in premature infants

Objective To study the prevalence of intraventficular hemorrhage(IVH)in premature infants using bedside cranial ultrasound scans and to analyze the associated laboratory results.Methods 114 patients admitted between February 2003 and March 2004 were eligible for the study.NAS-2000A 3D ultrasound instrument for bedside ultrasound detection were used.All the premature infants were detected for blood gas analysis,blood cell analysis(red blood cell counting,haemoglobin and haematocrit),prothrombin time (PT),fibrinogen(FIB)and activated partial thromboplastin time(APTT)in the first 24 hours of life.Results There were 34 IVH cases in 114 patients(29.8%).The ineidence of IVH of premature infants below 34 weeks gestation was 43.8%,which was higher than that of infants above 35 weeks gestation.The incidence of IVH of infants whose birth weight were below 1 500 g is 58.8%,which was higher than that of infants whose birth weight were above 1 500 g.The incidence of IVH increased with decreasing gestational age and birth weight.As compared with the values of infants without IVH,HB and HCT of the IVH infants were higher (P＜0.05);PT and APTT of the IVH inrants were longer(P＜0.01);hypoxia,hypercapnia and acidosis were more common in IVH infants(P＜0.05).Conclusion Risk factors such as short gestational age,low birth weight,increased HB and HCT,prolongation of PT and APTT,hypoxia,hypercapnia and acidosis may be associated with the IVH in premature infants.