早产儿脑室扩大的临床特点及其危险因素分析

目的：探讨早产儿脑室扩大（VD）的临床特点及其发生的危险因素。方法对2008-11-2009-11在NICU病房住院的313例于生后3－7d进行头颅B超检查的早产儿资料进行回顾性分析，其中24例诊断VD患儿为病例组，289例脑室正常患儿为对照组，分析两组病例的临床特点及预后并进行早产儿VD相关危险因素分析。结果早产儿VD发生率7.67%，其中胎龄＜28、28－30及≥30周的早产儿VD发生率分别为33.33%、23.29%和1.73%，出生体重＜1500、1500－2000及≥2000g的早产儿VD发生率分别为26.53%、9.00%和2.15%。病例组病死率为4.17%，对照组为2.12%，两组比较差异无统计学意义。单因素分折结果显示，早产儿VD的相关因素包括：胎龄、出生体重、血糖、血pH值、贫血、呼吸机治疗；logistic回归多因素分折结果显示：胎龄、出生体重、呼吸机治疗是早产儿VD的独立危险因素。结论小胎龄、低出生体重、应用呼吸机治疗是早产儿VD的危险因素，进一步开展相关因素预防措施的研究是降低早产儿VD的关键。

Risk factors of ventricular dilatation in premature infants

Objective To investigate the risk factors and outcomes of ventricular dilatation （VD） in premature infants. Methods Three hundred and thirteen premature infants, who underwent head ultrasonography examination at d3-d7 after birth in NICU during November 2008 and November 2009. The clinical characteristics were retrospectively reviewed and risk factors were analyzed with non- conditional logistic regression. Results There were 24 episodes of VD （7.67%） in 313 premature infants. The incidence of VD was 24.4% （20/82） in infants with gestational age at birth 〈30 weeks and the incidence of VD was 15.8%（20/127） in infants with birth weight〈2 000g. Single factor analysis showed that VD in premature infants was significantly associ-ated with gestational age, birth weight, blood PH values, blood sugar, anemia and mechanical ventilation. Multivariate logistic re-gression analysis revealed that low gestational age, low birth weight and mechanical ventilation were independent risk factors for VD. Conclusion VD occur at significant rates among premature infants and is associated with low gestation age, low birth weight and mechanical ventilation.