Abstract: Objective　To investigate the related influencing factors and comprehensive intervention effect of intracranial hemorrhage in premature infants. Methods　The clinical data of 158 premature infants delivered in Foshan Maternal and Child Health Hospital from January 2019 to May 2022 were retrospectively analyzed, including 78 males and 80 females, with a gestational age of 28-36 (32.11±0.85) weeks. All premature infants underwent cranial ultrasound within 3 days after birth. The premature infants were divided into an intracranial hemorrhage group and a non-intracranial hemorrhage group according to whether intracranial hemorrhage occurred. The basic data of gestational age, gender, birth weight, delivery mode, intrauterine asphyxia, maternal premature rupture of membranes, maternal pregnancy induced hypertension, maternal prenatal use of dexamethasone, mechanical ventilation therapy, acidosis within 12 hours after birth, history of high concentration oxygen inhalation, and electrolyte disorder of the two groups were collected, single factor analysis was performed first, multi-factor logistic regression analysis was further carried out for the obtained items with statistically significant differences, and independent risk factors affecting intracranial hemorrhage in premature infants were finally obtained. Chi-square test was used. Results　Among the 158 premature infants, 15 cases of intracranial hemorrhage were detected by cranial ultrasound, with an incidence of 9.49% (15/158). Univariate analysis showed that gestational age, birth weight, intrauterine asphyxia, maternal prenatal use of dexamethasone, mechanical ventilation therapy, acidosis within 12 h after birth, and history of high concentration oxygen inhalation were correlated with the occurrence of intracranial hemorrhage in preterm infants, with statistically significant differences (all P<0.05). Multivariate analysis showed that gestational age <32 weeks, birth weight <1 500 g, intrauterine asphyxia, no maternal prenatal use of dexamethasone, mechanical ventilation therapy, acidosis within 12 h after birth, and history of high concentration oxygen inhalation were all independent risk factors for intracranial hemorrhage in preterm infants (all OR>1, P<0.05). Conclusions　Gestational age <32 weeks, birth weight <1 500 g, intrauterine asphyxia, no maternal prenatal use of dexamethasone, mechanical ventilation therapy, acidosis within 12 h after birth, and history of high concentration oxygen inhalation are all independent risk factors for intracranial hemorrhage in preterm infants. It is necessary to identify these risk factors as early as possible and formulate targeted intervention measures to reduce the occurrence of intracranial hemorrhage.

Key words: 早产儿, 颅内出血, 影响因素, 干预效果

摘要： 目的　探讨早产儿颅内出血的相关影响因素及综合干预效果。方法　回顾性分析2019年1月至2022年5月于佛山市妇幼保健院分娩的158例早产儿临床资料，其中男78例，女80例，胎龄28～36（32.11±0.85）周。所有早产儿均于出生3 d内开展颅脑超声检查。依据早产儿是否发生颅内出血分为颅内出血组及非颅内出血组，收集两组胎龄、性别、出生体质量、分娩方式、宫内窒息、母体胎膜早破、母体妊高症、母体产前使用地塞米松、机械通气治疗、出生12 h内酸中毒、高浓度吸氧史、电解质紊乱等多方面基础资料，先行单因素分析，待获得差异有统计学意义的项目后开展多因素logistic回归分析，最终获取影响早产儿颅内出血发生的独立危险因素。采用χ²检验。结果　158例早产儿经颅脑超声检查出15例颅内出血患儿，发生率为9.49%（15/158）；单因素分析显示，胎龄、出生体质量、宫内窒息、母体产前使用地塞米松、机械通气治疗、出生12 h内酸中毒、高浓度吸氧史与早产儿颅内出血发生相关，差异均有统计学意义（均P<0.05）；多因素分析显示，胎龄<32周、出生体质量<1 500 g、宫内窒息、母体产前未使用地塞米松、机械通气治疗、出生12 h内酸中毒、高浓度吸氧史均为早产儿颅内出血的独立危险因素（均OR>1，P<0.05）。结论　胎龄<32周、出生体质量<1 500 g、宫内窒息、母体产前未使用地塞米松、机械通气治疗、出生12 h内酸中毒、高浓度吸氧史为早产儿颅内出血的独立危险因素，临床需尽早识别该类危险因素，制定针对性干预措施，以减少颅内出血发生。

关键词: 早产儿, 颅内出血, 影响因素, 干预效果