新生儿颅内出血危险因素及预防措施研究

目的探讨新生儿颅内出血的类型及其可能的危险因素,研究预防措施。方法选择2004-2009年住院的180例颅内出血新生儿为病例组,同期住院的200例非颅内出血新生儿为对照组进行病例对照研究。单因素分析用卡方检验,多因素分析用多元Logistic回归分析。结果病例组中出血部位发生率由高到低依次为脑室周围-脑室内出血、蛛网膜下腔出血、脑实质出血、硬膜下出血、小脑出血。产程延长、产钳、低出生体重儿、过期产、巨大儿、母亲感染发热、母亲产前出血、脐带绕颈、胎儿宫内窘迫、胎盘老化、胎头吸引、胎位异常、臀位牵引、新生儿呼吸困难、新生儿低血糖、新生儿酸碱失衡、新生儿出血病、新生儿休克、新生儿血小板减少、新生儿窒息、早产儿均是新生儿颅内出血的相关危险因素。结论减少早产,提高产科质量,控制感染,预防出血,维持内环境稳定,可降低新生儿颅内出血的发生率。

The Study of risk factors and preventive measures for neonatal intracranial hemorrhage

Objective: To study the risk factors and preventive measures for neonatal Intracranial Hemorrhage.Methods: Selected 180 patients hospitalized because of neonatal intracranial hemorrhage as the case group and 200 cases with no-neonatal intracranial hemorrhage as control group.Results: The incidence of bleeding site from high to low was periventricular-intraventricular hemorrhage,subarachnoid hemorrhage,cerebral hemorrhage,subdural hemorrhage,cerebellar hemorrhage in patient group.The multivariate logistic stepwise regression analysis showed that forceps,low birth weight children,great children,cord around neck,fetal distress,fetal head to attract,abnormal fetal position,breech traction,neonatal acid-base imbalance,neonatal asphyxia and premature birth were the risk factors of neonatal Intracranial Hemorrhage.Conclusion: Reduce preterm birth,improve quality of obstetrics,control infection,prevent bleeding,and maintain stable internal environment,can reduce the incidence of neonatal intracranial hemorrhage.