【摘要】：目的:通過研究早產兒腦損傷的高危因素,避免高危因素的發(fā)生,從而降低早產兒腦損傷的發(fā)病率,改善早產兒的預后,提高其生活質量。方法:研究近3年來新生兒科住院早產兒的頭顱磁共振成像檢查,根據頭顱MRI結果將有異常表現的設為早產兒腦損傷組,無異常為對照組。其中腦損傷組又分為單純缺氧缺血性損傷組,單純出血性損傷組,以及兩者混合性損傷組。詳細統(tǒng)計臨床資料,通過對相關因素分析,行Logistic回歸分析統(tǒng)計學方法,篩選出與早產兒腦損傷有關的危險因素,以及不同腦損傷組的危險因素。結果:1.納入調查范圍內的早產兒共229例,其中診斷為早產兒腦損傷85例;對照組144例。早產兒腦損傷組中單純缺氧缺血性損傷21例,單純出血性損傷52例,兩者混合性損傷12例。2.通過Logistic回歸分析提示:(1)胎齡、胎膜早破、分娩方式、BE、機械通氣、新生兒感染與早產兒腦損傷的發(fā)生有關,有統(tǒng)計學意義(p0.05);其中小胎齡、低BE值為危險因素。(2)單純缺氧缺血性損傷組:低BE值、新生兒感染為危險因素;單純出血性損傷組:新生兒感染、胎膜早破、機械通氣為危險因素;混合性腦損傷組:機械通氣為危險因素。結論:1.早產兒腦損傷是多種因素相互作用的結果,其發(fā)病基礎是早產兒發(fā)育的不成熟和易感性。2.小胎齡、胎膜早破、低BE值、機械通氣、新生兒感染是早產兒腦損傷的危險因素。
[Abstract]:Objective: to study the high risk factors of brain injury in premature infants, to avoid the occurrence of high risk factors, to reduce the incidence of brain injury in preterm infants, to improve the prognosis of premature infants and to improve their quality of life. Methods: the cranial magnetic resonance imaging of premature infants in recent 3 years was studied. According to the results of cranial MRI, the abnormal findings were divided into premature infants with brain injury group and no abnormal group as control group. The brain injury group was divided into simple hypoxic-ischemic injury group, hemorrhagic injury group, and mixed injury group. The clinical data were analyzed in detail and the risk factors related to brain injury of premature infants and different brain injury groups were screened by Logistic regression analysis. The result is 1: 1. A total of 229 premature infants were included in the study, including 85 cases of brain injury diagnosed as premature infants and 144 cases of control group. There were 21 cases of pure hypoxic-ischemic injury, 52 cases of hemorrhagic injury and 12 cases of mixed injury. Logistic regression analysis showed that: (1) gestational age, premature rupture of membranes, mode of delivery, BE, mechanical ventilation and neonatal infection were associated with brain injury in premature infants (p0.05); Among them, small gestational age, low BE value is the risk factor. (2) simple hypoxic-ischemic injury group: low BE value, neonatal infection as a risk factor, hemorrhagic injury group: neonatal infection, premature rupture of fetal membranes, mechanical ventilation as a risk factor; Mixed brain injury group: mechanical ventilation was the risk factor. Conclusion: 1. Brain injury in premature infants is the result of the interaction of many factors, and its pathogenesis is based on premature infants' immature development and susceptibility. 2. Small gestational age, premature rupture of membranes, low BE, mechanical ventilation and neonatal infection were risk factors of brain injury in premature infants.
【學位授予單位】：皖南醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R722.6

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