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目的:早产儿进行体外氧化隔膜(ECMO)治疗后, 可引发颅内出血(ICH)本文研究患儿年龄对引发颅内出血风险的影响。方法:本文为回顾性定群研究,从1992-2000年间早产儿护理情况登记处的记录资料中,收集到符合试验标准的病例1524例,患儿胎龄均为小于37周,且接受体外氧化隔膜(ECMO)治疗。与ICH相关的患者年龄可定义为胎龄、出生后年龄(PNA) 和孕龄(PCA),利用多变量logistic回归分析进行数据处理,获得颅内出血和患者年龄间的关系。结果:PNA 和ICH在单因素相关分析中呈反比例关系(P=0.01), 而在多元分析中则无此关系(P=0.36)。随着PCA增长,ICH患儿数量明显下降,二者呈显著性相关:PCA小于32周的患儿,有26%患有ICH;相比之下,PCA为38 周的患儿中发病率为6%(P=0.004)。用多变量logistic 回归分析,检验ICH的独立预测因素:PCA(P= 0.005)、脓毒败血症(P=0.004)、酸中毒(P=0.004)和碳酸氢钠治疗(P=0.002)。当统计过程加入PNA的时候,则胎龄和ICH仅在多元模式中具有相关性。结论: 对于用ECMO治疗的早产婴儿,PNA不是预测ICH发生的显著性指标,而PCA则与ICH的发生具有很好的年龄相关性,可作为显著性预测指标。
OBJECTIVE: Intracranial hemorrhage (ICH) can be triggered after ECMO treatment in preterm infants. This article investigates the impact of children’s age on the risk of intracranial hemorrhage. METHODS: This retrospective cohort study included 1524 eligible cases from a registry of records of care in preterm infants from 1992 to 2000, with gestational age less than 37 weeks and in vitro oxidation Diaphragm (ECMO) treatment. The patient age associated with ICH can be defined as gestational age, postnatal age (PNA) and gestational age (PCA), and multivariate logistic regression analysis was used to determine the relationship between intracranial hemorrhage and patient’s age. Results: PNA and ICH were inversely proportional to one-way correlation analysis (P = 0.01), but not multivariate analysis (P = 0.36). As PCA increased, there was a significant decrease in the number of children with ICH, which was significantly correlated: 26% of children with PCA less than 32 weeks had ICH; compared with 38% of children with PCA 6% (P = 0.004). Multivariate logistic regression analysis was used to test for independent predictors of ICH: PCA (P = 0.005), sepsis (P = 0.004), acidosis (P = 0.004) and sodium bicarbonate treatment (P = 0.002). When the statistical process was added to PNA, gestational age and ICH were only correlated in multivariate mode. CONCLUSION: PNA is not a significant predictor of ICH in preterm infants treated with ECMO, whereas PCA has a very good age-related association with ICH and can be used as a predictor of outcome.