目的：探讨早产儿脑室周围-脑室内出血（ PIVH）的高危因素。方法对2010年1月至2011年12月期间，在西安高新医院分娩后收住新生儿病区及新生儿重症监护室的早产儿126例，根据床旁颅脑B超、临床诊断结果分为脑室内出血组（72例）和无脑室内出血组（54例），并进行对比分析。结果126例早产儿中脑室周围-脑室内出血发生率为57．1％（72/126），其中重度PIVH发生率29．2％（21/72）。胎龄≤32周或体重≤1500g的早产儿PIVH的发生率明显高于胎龄＞32周或体重＞1500g的早产儿，差异有统计学意义（χ2值分别为18．81和9．78，均P＜0．05）。与无PIVH组相比，PIVH组患儿在宫内窘迫（20例vs 10例）、新生儿呼吸窘迫综合征（18例vs 7例）、血小板减少（12例vs 4例）、生后感染（23例vs 11例）等方面比较，差异有统计学意义（χ2值分别为8．10、5．62、11．23、13．40，均P＜0．05）。 Logistic回归分析结果显示胎龄≤32w、窒息、机械通气、血小板减少、生后感染是发生PIVH的危险因素。结论早产儿脑室周围-脑室内出血与胎龄、出生体重、窒息程度、机械通气、宫内窘迫、血小板减少和生后感染等因素相关；加强产前监护、提高产科技术，综合防治可减少PIVH发生，提高早产儿抢救成功率，减少后遗症的发生。%Objective To explore the high risk factors of periventricular-intraventricular hemorrhage ( PIVH ) in premature infants . Methods A total of 126 premature infants admitted in neonates ward and NICU during the period of January 2010 to December 2011 in Xi’an Hi-Tech Park Hospital were divided into intraventricular group (n=72) and non PIVH group (n=54) according to 2D cranial ultrasonography and clinical diagnosis results .The results were compared .Results The incidence rate of PIVH among 126 premature infants was 57.1%(72/126), of which 29.2%(21/72) were severe cases.The incidence rate of PIVH among premature infants with gestational age ≤32 weeks or birth weight ≤1500 grams was significantly higher than that with gestational age >32 weeks or birth weight>1 500 grams (χ2 value was 18.81 and 9.78, respectively, both P<0.05).Compared with the infants without PIVH , the differences in fetal distress (20 cases vs 10 cases), NRDS (18 cases vs 7 cases), thrombocytopenia (12 cases vs 4 cases) and postnatal infection (23 cases vs 11 cases) were statistically significant (χ2 value was 8.10, 5.62, 11.23 and 13.40, respectively, all P<0.05).Logistics regression analysis revealed that PIVH occurrence in infants was more closely related with such factors as gestational age ≤32w, asphyxia, mechanical ventilation , thrombocytopenia and postnatal infection .Conclusion Occurrence of PIVH is associated with such factors as gestational age, birth weight, asphyxia, mechanical ventilation, fetal distress, thrombocytopenia as well as postnatal infection . Strengthening prenatal care , improving obstetric techniques and integrated prevention can reduce the occurrence of PIVH , improve the survival rate of preterm infants and reduce the incidence of complications .
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