超早产儿脑室内出血的风险因素分析
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1.南京医科大学第一附属医院儿科;2.南京医科大学第一附属医院放射科

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The risk factors of intraventricular hemorrhage in extremely preterm infants
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the First Affiliated Hospital of Nanjing Medical University

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    摘要:

    目的:研究胎龄小于28周的超早产儿发生严重脑室内出血(intraventricular hemorrhage, IVH)的相关危险因素。方法:回顾性收集2016 年至 2021 年间的118名超早产儿的临床资料,并通过单因素和多因素Logistic回归模型分析超早产儿发生重度IVH的风险因素。结果:单因素分析显示与超早产儿脑室内出血相关的因素有:更小的胎龄、更低的Apgar评分、产前没给予类固醇激素、机械通气、肺出血、高级别的呼吸窘迫综合征(respiratory distress syndrome, RDS)、低血压、高频率的高血糖发作、多次气管插管、较长时间的静脉置管(都有P<0.05)。多因素回归分析显示,低血压(OR=3.508,P=0.021)、较高频率的高血糖发作(OR=5.333,P=0.022)、重度RDS(OR=5.583,P=0.001)、多次气管插管(OR=4.566,P =0.006)和较长的静脉置管手术时间(OR=4.207,P=0.040)等风险因素与重度IVH显著相关。结论:低血压、重度 RDS、多次气管插管、较高频率的高血糖发作和静脉置管手术时间较长是超早产儿发生重度 IVH的风险因素。

    Abstract:

    Objective:To study the risk factors of intraventricular hemorrhage in extremely preterm infants. Methods: We retrospectively evaluated 118 extremely preterm infants between 2016 and 2021. The association between risk factors and severe IVH was assessed by univariate and multivariate logistic regression analyses. Results: Univariate analysis revealed the following risk factors were associated with severe IVH in extremely preterm infants: smaller gestation age, lower Apgar score, lack of antenatal steroid administration, catecholamine administration, invasive respiratory support, pulmonary hemorrhage, high grade respiratory distress syndrome (RDS), hypotension, higher frequency of hyperglycemic episodes, multiple tracheal intubations and longer operation duration of venous catheterizations. In a multivariable logistic regression model, hypotension(OR=3.508,P =0.021), higher frequency of hyperglycemic episodes(OR=5.333,P =0.022), high grade RDS(OR=5.583,P =0.001), multiple tracheal intubations(OR=4.566,P=0.006), longer operation duration of venous catheterization(OR=4.207,P=0.040)remained statistically significantly associated with severe IVH. Conclusion: Hypotension, high grade RDS, multiple tracheal intubations, higher frequency of hyperglycemic episodes and longer operation duration of venous catheterization were strongly associated with higher risk of severe IVH in extremely preterm infants.

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  • 收稿日期:2022-10-09
  • 最后修改日期:2023-01-29
  • 录用日期:2023-07-09
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