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新生儿期疾病及治疗对早产儿发生脑性瘫痪的影响

Influence of Neonatal Diseases and Treatments on the Development of Cerebral Palsy in Preterm Infant

  • 摘要: 目的 分析早产儿在新生儿期合并疾病及治疗方法与之后发生脑性瘫痪(简称脑瘫)的相关性。 方法 选取2005年4月至2011年8月在四川大学华西第二医院儿童神经发育与康复中心就诊脑瘫患儿为病例组,同期在该院住院随访正常早产儿为对照组;以早产儿常见新生儿期疾病及治疗方法作为早产儿发生脑瘫的危险因素,进行非条件logistic回归分析。 结果 多因素logistic逐步回归分析显示:脑室周围白质软化(OR=39.87,P<0.05)、缺氧缺血性脑病(OR=4.24,P<0.05)、新生儿低血糖(OR=2.18,P<0.05)、新生儿高间接胆红素血症(OR=1.72,P<0.05)、呼吸道持续正压通气(OR=0.21,P<0.05)与早产儿发生脑瘫有关。 结论 脑室周围白质软化、新生儿缺氧缺血性脑病、新生儿低血糖、新生儿高间接胆红素血症可增加早产儿发生脑瘫风险,而呼吸道持续正压通气可能减少高危早产儿发生脑瘫风险。

     

    Abstract: Objective To investigated the risk factors of cerebral palsy development in preterm infants. Methods This study included 203 preterm infants (gestation age<37 weeks) diagnosed with cerebral palsy (CP) and 220 preterm infants without cerebral palsy or any other severe neurological disorders during April 2005 to August 2011. The risk factors in the development of cerebral palsy, including the diseases of premature infants and the treatments in neonatal period, were analyzed by multiple logistic regression analysis. Results Multivariate logistic analysis for the risk factors associated with cerebral palsy in neonatal period found significant differences in the occurrence of periventricular leukomalacia (PVL, OR=39.87, P<0.05), hypoxia-ischemic encephalopathy (HIE, OR=4.24, P<0.05), hypoglycemia of neonatal (OR=2.18, P<0.05), neonatal hyperbilirubinemia (OR=1.72, P<0.05), continuous positive airway pressure (CPAP, OR=0.21, P<0.05). Conclusion The factors including PLV, HIE, hypoglycemia, and neonatal jaundice may increase the risk in the development of CP in preterm infant. while CPAP may decrease the risk of cerebral palsy.

     

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