摘要
目的观察高危新生儿视网膜出血的特征及其与颅内出血的关系。方法对183例高危新生儿的视网膜出血情况进行分析,观察其出血形态及部位,记录其颅脑情况,追踪随访出血吸收情况。结果183例高危新生儿中,有视网膜出血者111例(60.7%),有颅内出血者53例(29.0%)。单因素χ^(2)分析显示,出生低体重、早产、顺产、新生儿窒息、新生儿肺炎、母亲妊娠糖尿病、视网膜多层出血与颅内出血的发生相关,差异有统计学意义(P<0.05);其余因素与颅内出血的发生,差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,出生低体重、顺产、新生儿窒息、新生儿肺炎、母亲妊娠糖尿病是颅内出血的影响因素(P=0.016、0.01、0.002、0.003、0.007,P<0.05)。单因素χ^(2)分析显示,顺产、新生儿窒息、新生儿肺炎与视网膜出血的发生相关,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,顺产、新生儿窒息是视网膜出血的危险因素(P=0.001、0.009,P<0.05)。结论出生低体重、顺产、新生儿窒息、新生儿肺炎、母妊娠糖尿病是高危新生儿颅内出血的危险因素,顺产、新生儿窒息是高危新生儿视网膜出血的危险因素。所以对于顺产合并有新生儿窒息的高危新生儿,要及时行颅脑相关检查及眼底检查,以早期发现颅内出血及视网膜出血,尤其是视网膜多层出血。对于重度颅内出血及视网膜多层出血者早期进行干预,避免新生儿脑瘫及弱视的发生。
Objective To observe the characteristics of retinal hemorrhage in high risk neonates and its relationship with craniocerebral hemorrhage.Methods A total of 183 neonates with retinal hemorrhage in high-risk neonates were analyzed.The morphology and location of bleeding were observed.The brain status was recorded and the bleeding was followed up.Results Among 183 high-risk newborns,111 patients had retinal hemorrhage,53 patients had brain hemorrhage.The incidence of retinal hemorrhage was 60.7%.The incidence of brain hemorrhage was 29.0%.χ^(2)analysis results showed that low birth weight,premature delivery,mode of delivery,neonatal asphyxia,neonatal pneumonia,gestational diabetes,multi-layer hemorrhage of the retina were associated with the occurrence of intracranial hemorrhage(P<0.05),multivariate logistic regression analysis showed that low birth weight,eutocia,neonatal asphyxia,neonatal pneumonia,and maternal gestational diabetes were the influencing factors of intracranial hemorrhage(P=0.016,0.01,0.002,0.003,0.007,P<0.05).χ^(2) analysis showed that the mode of delivery,neonatal asphyxia,and neonatal pneumonia were related to the occurrence of retinal hemorrhage,and the difference was statistically significant(P<0.05);multivariate logistic regression analysis showed that eutocia and neonatal asphyxia were risk factors of retinal hemorrhage(P=0.001,0.009,P<0.05).Conclusions Low birth weight,natural birth,neonatal asphyxia,neonatal pneumonia,and maternal gestational diabetes are risk factors affecting intracranial hemorrhage in high-risk newborns.Natural birth and neonatal asphyxia are risk factors affecting retinal hemorrhage in high-risk newborns.For high-risk neonates with neonatal asphyxia,specially multi-layer retinal hemorrhager,we need to check the brain and the fundus to avoid the occurrence of cerebral palsy and amblyopia in children.
作者
张建萍
韦美荣
ZHANG Jianping;WEI Meirong(Liuzhou Maternity and Child Healthcare Hospital,Affiliated Maternity Hospital and Affiliated Children’s Hospital of Guangxi University of Science and Technology Guangxi,Liuzhou,545001,China)
出处
《中国眼耳鼻喉科杂志》
2021年第2期109-113,共5页
Chinese Journal of Ophthalmology and Otorhinolaryngology
基金
广西壮族自治区卫生厅自筹经费科研课题(z2016544)。
关键词
高危新生儿
视网膜出血
颅内出血
High risk newborn
Retinal hemorrhage
Brain hemorrhage
