【摘要】：目的： 探討早產(chǎn)兒窒息的相關(guān)因素，為早產(chǎn)的治療提供相關(guān)臨床指導(dǎo)。 方法： 1.對2012年1月至2014年2月在重慶醫(yī)科大學(xué)附屬第二醫(yī)院產(chǎn)科住院分娩的早產(chǎn)病例按孕婦年齡、孕周、合并癥、分娩方式以及是否合并胎膜早破進(jìn)行統(tǒng)計，采用Logistic回歸分析上述因素與早產(chǎn)兒窒息的關(guān)系。 2.對185例未足月胎膜早破病例按破膜時間進(jìn)行分組，矯正其他相關(guān)因素對早產(chǎn)兒窒息的影響后，評價胎膜早破破膜時間對早產(chǎn)兒窒息的影響。 結(jié)果：共收集早產(chǎn)相關(guān)病例589例，排除不合格病歷43例，排除雙胎病例92例，選擇符合要求454例早產(chǎn)病例納入統(tǒng)計，結(jié)果如下： 1.孕婦的年齡對早產(chǎn)兒缺氧窒息無明顯影響（p0.05）。 2.孕周越小，早產(chǎn)兒發(fā)生缺氧窒息的概率越大(p0.05，回歸系數(shù)為-0.8939)。 3.孕婦合并HDCP、GDM、ICP、甲狀腺功能低下、甲狀腺功能亢進(jìn)、先天性心臟病、瘢痕子宮等合并癥明顯影響早產(chǎn)兒窒息率，母親孕期具有合并癥的早產(chǎn)兒發(fā)生窒息的概率是無合并癥早產(chǎn)兒的3.832倍（p0.05,OR值=3.832）。 4.胎兒分娩方式明顯影響早產(chǎn)兒窒息率，以剖宮產(chǎn)方式分娩的早產(chǎn)兒發(fā)生缺氧窒息的概率是以陰道分娩的早產(chǎn)兒的2.125倍(p0.05,OR值=2.125)。 5.胎膜早破對早產(chǎn)兒窒息的發(fā)生率無明顯影響（p0.05），但破膜時間影響早產(chǎn)兒發(fā)生窒息的概率，不同破膜時間對早產(chǎn)兒發(fā)生窒息的概率有明顯差異，破膜時間越長，早產(chǎn)兒窒息的發(fā)生率越大（p0.05，，回歸系數(shù)為0.5339）。 結(jié)論： 胎兒孕周、分娩方式、孕婦是否存在合并癥以及破膜時間的長短均是影響早產(chǎn)兒窒息的因素，而孕婦年齡對早產(chǎn)兒窒息發(fā)生沒有明顯影響。
[Abstract]:Objective: to explore the related factors of asphyxia in preterm infants and to provide clinical guidance for the treatment of preterm labor. Methods: 1. The number of premature deliveries in the second affiliated Hospital of Chongqing Medical University from January 2012 to February 2014 was calculated according to the age of the pregnant woman, gestational week, complications, mode of delivery and whether premature rupture of membranes occurred or not, Logistic regression was used to analyze the relationship between the above factors and asphyxia of preterm infants. 2. 185 cases of premature rupture of membranes were divided into groups according to the time of rupture of membranes. After correcting the influence of other related factors on asphyxia of premature infants, the effect of rupture time of premature membranes on asphyxia of preterm infants was evaluated. Results: a total of 589 cases related to preterm delivery were collected, 43 cases of unqualified medical records were excluded, 92 cases of twin births were excluded, 454 cases of premature delivery were selected and included in the statistics. The results are as follows: 1. The age of pregnant women had no significant effect on hypoxic asphyxia of preterm infants (p0.05). 2. The smaller the gestational age was, the higher the probability of hypoxic asphyxia occurred in premature infants (p 0.05, regression coefficient was-0.8939). 3. Pregnant women with HDCP,GDM,ICP, hypothyroidism, hyperthyroidism, congenital heart disease, scar uterus and other complications significantly affect the rate of premature asphyxia. The incidence of asphyxia in preterm infants with complications during pregnancy was 3.832 times higher than that in non-concomitant preterm infants (p 0.05, OR = 3.832). 4. The rate of premature asphyxia was significantly affected by the mode of fetal delivery. The probability of hypoxic asphyxia in preterm infants delivered by cesarean section was 2.125 times higher than that in preterm infants who were delivered by vagina (p 0.05, OR = 2.125). 5. Premature rupture of membranes had no significant effect on the incidence of asphyxia in preterm infants (p0.05), but the time of rupture of membranes affected the probability of asphyxia in preterm infants, and there was significant difference in the probability of asphyxia in preterm infants with different time of rupture of membranes. The higher the incidence of asphyxia in preterm infants (p 0.05, regression coefficient was 0.5339). Conclusion: gestational weeks, delivery mode, complications of pregnant women and the duration of rupture of membranes are all factors affecting asphyxia of preterm infants, but the age of pregnant women has no significant effect on the occurrence of asphyxia of preterm infants.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R722.6

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