目的 研究早产儿脑性瘫痪(CP)的高危因素,为早产儿脑性瘫痪的防治提供理论依据。方法 选取2008年10月-2014年10月在本院医治的70例早产儿CP患儿为观察对象;选取同期在本院进行体检的健康儿童140例作为对照组,对所有受试者的临床资料进行统计分析。结果 所有70例CP患儿均伴有不同程度运动障碍。单因素分析表明:既往不良产史、孕期反复阴道流血、高龄产妇、羊水异常、孕期感染、脐带绕颈、胎位不正、父亲饮酒、出生体重≤1.5 kg、难产、宫内窘迫、新生儿窒息、病理性黄疸、缺氧缺血性脑病及新生儿肺炎均与CP发病相关。多因素Logistic回归分析表明:既往不良产史、羊水异常、宫内窘迫、新生儿窒息、病理性黄疸及缺氧缺血性脑病为CP的危险因素。结论 CP的发生受产前、产时、产后各个时期的多种因素影响,应结合已发现的CP高危因素进行积极预防,做好孕期监测,产前检查及围生期保健,以期降低CP发生率。

Objective To provide the theory for the prevention and treatment of premature cerebral palsy,and analyze the relationship between the risk factors and premature cerebral palsy. Methods From Oct.2008 to Oct.2014,70 cases of cerebral palsy from the disabled rehabilitation were selected as research object,140 cases of healthy examined children were selected as control group with the corresponding period.The clinical data of all the subjects were analyzed. Results A total of 70 cases of cerebral palsy were all accompanied by different degree of movement disorders.For single factor analysis,the history of bad production,repeated vaginal bleeding during pregnancy,elderly parturient,abnormal amniotic fluid,pregnant infection,cord around neck,malposition,whose fathers drank,weight ≤1.5 kg,dystocia,fetal intrauterine distress,neonatal asphyxia,pathologic jaundice,hypoxic ischemic encephalopathy,pneumonia of newborn were all related with cerebral palsy.For Logistic analysis,the history of bad production,abnormal amniotic fluid,fetal intrauterine distress,neonatal asphyxia,pathologic jaundice,hypoxic ischemic encephalopathy,pneumonia of newborn were all risk factors for cerebral palsy. Conclusions Cerebral palsy is related with a variety of factors during antepartum and intrapartum and postpartum periods.Positive prevention,pregnancy examination and perinatal care according to the risk factors for cerebral palsy would reduce the incidence of cerebral palsy.