极低出生体质量新生儿DIC高危因素分析

目的调查分析极低出生体质量新生儿（VLBWI）弥散性血管内凝血（DIC）高危因素，以便早期干预。方法回顾性分析2010年11月～2011年10月我院NICU住院治疗VI。BWI78例DIC发生情况，分析DIC组与非DIC组基本资料、围生期情况、并发症及治疗方面的差异，并对相关危险因素行Logistic回归分析。结果78例VI。BWI发生DIC26例，存活74例（94．9％）。DIC组与非DIC组胎龄、出生体质量、宫内生长迟缓（IUGR）、窒息、败血症、低体温、肺出血、贫血、呼吸衰竭和消化道出血情况比较差异有显著性（t=2．095、3.100，x^2=4．524～18．567，P〈0．05）；Logistic回归分析显示，IUGR、窒息、败血症、低体温、贫血及呼吸衰竭是VLBWI发生DIC的高危因素（x^2=4．325～17．175，P〈0.05）。结论VLBWI是DIC高危人群，胎龄、出生体质量、IuGR、窒息、败血症、低体温、贫血、呼吸衰竭、肺出血、消化道出血与DIC发生有关，其中IUGR、窒息、败血症、低体温、贫血及呼吸衰竭是VLBWI发生DIC的高危因素。胎龄越小，体质量越低，越易发生DIC。

HIGH RISK FACTORS OF DISSEMINATED INTRAVASCULAR COAGULATION IN VERY LOW BIRTH-WEIGHT INFANTS

Objective To investigate and analyse high risk factors of disseminated intravascular coagulation （DIC） in very low birth-weight infants （VLBWIs）, so as to offer an early intervention. Methods Clinical data of 78 VLBWIs treated in the neonatal intensive care unit （NICU） between November 2010 and October 2011 were reviewed retrospectively for the incidence of DIC, the information of those in DIC and non-DIC groups was analyzed for their perinatal period, complications, and outcome, Lo- gistic regression analysis was employed for the correlated risk factors. Results Twenty-six of the 78 VLBWIs were diagnosed with DIC, 74（94. 9%） survived. The differences between DIC and non DIC group were significant in terms of gestational age, birth weight, intrauterine growth retardation （IUGR）, asphyxia, septicemia, hypothermia, pulmonary hemorrhage, anemia, re spiratory failure, and alimentary tract hemorrhage （t=2. 095,3. 100;x^2=4. 524-18. 567;P〈0.05）. Logistic regression analysis showed that IUGR, asphyxia, septicemia, hypothermia, pulmonary hemorrhage, anemia, and respiratory failure were the high- risk factors for DIC （x^2=4. 325-17. 175,P〈0.05）. Conclusion VLBWI is the high-risk group of DIC, which is associated with gestational age, birth weight, IUGR, asphyxia, septicemia, anemia, pulmonary hemorrhage, anemia, respiratory failure, and alimentary tract hemorrhage, in which, IUGR, asphyxia, septicemia, hypothermia, anemia and respiratory failure are risk factors for DIC. For those with younger gestational age and lighter birth weight, more DIC will be involved.