低钠血症对脑室周围-脑室内出血早产儿并发脑积水的影响

doi:10.3969/j.issn.1671-7171.2021.09.029

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摘要【目的】探讨低钠血症对脑室周围-脑室内出血(PVH-IVH)早产儿并发脑积水的影响,为临床防治早产儿PVH-IVH脑积水提供参考。【方法】选取2018年1月30日至2019年5月30日在本院出生并接受治疗的155例PVH-IVH早产儿,根据出生后14 d内是否发生脑积水将其分为对照组(PVH-IVH患儿,n=115)和观察组(PVH-IVH并发脑积水患儿,n=40)。检测出生24 h内生化指标并收集患儿临床资料,分析低钠血症与PVH-IVH并发脑积水相关性,并分析PVH-IVH并发脑积水的影响因素。【结果】155例PVH-IVH早产儿中共40例发生脑积水,发生率为25.8%。观察组病死率(25.0%,10/40)高于对照组(11.3%,13/115),差异有统计学意义(χ²=4.405,P=0.036)。观察组胎龄、出生体重低于对照组,男性、重度窒息、Ⅲ~Ⅳ级PVH-IVH、代谢性酸中毒、低钠血症、低血糖症比例高于对照组,差异均有统计学意义(P<0.05)。Logistic多因素分析结果显示,重度窒息、PVH-IVH分级、低钠血症、胎龄是PVH-IVH发生脑积水的独立影响因素(P<0.05)。【结论】PVH-IVH并发脑积水早产儿预后差,低钠血症是PVH-IVH发生脑积水的独立危险因素,及早纠正低钠血症对预防PVH-IVH并发脑积水具有重要意义。

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	孙惠
	樊巧玲

关键词 ：脑出血/并发症, 脑室, 脑积水/并发症, 低钠血症, 婴儿,早产

Abstract：【Objective】 To investigate the effect of hyponatremia on hydrocephalus in preterm infants with periventricular intraventricular hemorrhage (PVH-IVH).【Methods】 A total of 155 premature infants with pvh-ivh born and treated in our hospital from January 30, 2018 to May 30, 2019 was divided into control group (children with PVH-IVH, n=115) and observation group (children with PVH-IVH complicated with hydrocephalus, n=40) according to whether hydrocephalus occurred within 14 days after birth. The biochemical indexes within 24 hours of birth and the clinical data of children were detected, and the correlation between hyponatremia and PVH-IVH complicated with hydrocephalus, and the influencing factors of PVH-IVH complicated with hydrocephalus were analyzed. 【Results】 Hydrocephalus occurred in 40 of 155 premature infants with PVH-IVH, with an incidence of 25.8%. The mortality of the observation group (25.0%, 10/40) was higher than that of the control group (11.3%, 13/115)(χ²=4.405,P=0.036). The gestational age and birth weight of the observation group were lower than those of the control group, and the proportions of male, severe asphyxia, Grade Ⅲ-Ⅳ PVH-IVH, metabolic acidosis, hyponatremia and hypoglycemia were higher than those of the control group (P<0.05). Logistic multivariate analysis showed that severe asphyxia,PVH-IVH grade, hyponatremia and gestational age were independent influencing factors of PVH-IVH hydrocephalus (P<0.05). 【Conclusion】 The prognosis of premature infants with PVH-IVH complicated with hydrocephalus is poor. Hyponatremia is an independent risk factor for hydrocephalus in PVH-IVH. Early correction of hyponatremia is of great significance to prevent PVH-IVH complicated with hydrocephalus.

Key words： Cerebral Hemorrhage/CO Cerebral Ventricles Hydrocephalus/CO Hyponatremia Infant, Premature

收稿日期: 2021-03-30

中图分类号:

R743.34

通讯作者: *E-mail:262432903@qq.com

引用本文:

孙惠, 樊巧玲. 低钠血症对脑室周围-脑室内出血早产儿并发脑积水的影响[J]. 医学临床研究, 2021, 38(9): 1382-1384.
SUN Hui, FAN Qiao-ling. Effect of Hyponatremia on Periventricular Intraventricular Hemorrhage and Hydrocephalus in Preterm Infants. JOURNAL OF CLINICAL RESEARCH, 2021, 38(9): 1382-1384.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.09.029 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I9/1382

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