以磁共振成像诊断早产儿脑损伤相关危险因素的回顾性分析

被引：55

作者：

段洋 ^{[1
]}

毛健 ^{[1
]}

富建华 ^{[1
]}

李娟 ^{[1
]}

薛辛东 ^{[1
]}

王晓明 ^{[2
]}

陈丽英 ^{[2
]}

机构：

[1] 中国医科大学盛京医院新生儿科

[2] 中国医科大学盛京医院放射科

来源：

中国循证儿科杂志 | 2007年 / 06期

关键词：

磁共振成像; 早产儿; 出血性脑损伤; 缺血性脑损伤; 危险因素;

D O I：

暂无

中图分类号：

R445.2 [核磁共振成像]; R722.6 [早产儿疾病];

学科分类号：

100202 [儿科学]; 100231 [临床病理学];

摘要：

目的探讨以MRI诊断的早产儿脑损伤的相关危险因素。方法回顾性分析中国医科大学盛京医院2年中早产儿脑损伤相关危险因素,以MRI(T1WI-T2WI)和弥散加权成像诊断早产儿脑损伤,详细统计临床资料,进行单因素分析,对单因素分析有统计学意义的因素行早产儿脑损伤主要危险因素的Logistic回归分析。结果358例早产儿中,无脑损伤177例,有脑损伤181例,其中缺血性脑损伤占70.7%(128/181);单纯出血性脑损伤占53.0%(96/181);缺血伴出血性脑损伤占23.7%(43/181)。对21种危险因素进行分析。单因素分析:急产、双胎妊娠、母孕期感染、循环障碍、产道分娩、代谢性酸中毒、低钠血症、低钙血症与早产儿出血性脑损伤有统计学意义;母孕期感染、母孕期糖尿病、产前使用硫酸镁、复苏抢救史、循环障碍、产道分娩、代谢性酸中毒、低钠血症、低钙血症与早产儿缺血性脑损伤有统计学意义。Logistic分析示:母孕期感染(OR=4.738,95%CI:1.201～18.685,P<0.05)、产道分娩(OR=9.191,95%CI:4.699～17.979,P<0.05)、低钠血症(OR=3.244,95%CI:1.173～8.969,P<0.05)和低钙血症(OR=3.162,95%CI:1.325～7.545,P<0.05)是早产儿出血性脑损伤的危险因素;母孕期糖尿病(OR=5.211,95%CI:1.272～21.341,P<0.05)、产道分娩(OR=3.078,95%CI:1.824～5.194,P<0.05)、低钠血症(OR=3.331,95%CI:1.506～7.366,P<0.05)和低钙血症(OR=4.713,95%CI:2.412～9.209,P<0.05)是早产儿缺血性脑损伤的危险因素,产前使用硫酸镁(OR=0.375,95%CI:0.183～0.766,P<0.05)是其保护因素。结论母孕期感染、母孕期糖尿病等宫内暴露因素,分娩过程及出生后内环境紊乱均为早产儿脑损伤的危险因素,因此早产儿脑损伤是多种因素相互作用的复杂结果。在围生期的诊断治疗工作中应当尽量避免这些因素,减少神经系统并发症及降低其严重程度。

引用

页码：427 / 433

页数：7

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