Long Term Clinical Study Of Periventricular Leukomalacia In Preterm In Preterm Infants

Objective: To investigate the high risk factors which are closely related to periventricular leukomalacia in preterm infants, we analyze the different characteristics of the clinical manifestations, diagnosis and treatment of clinical efficacy and take different measures have made. In order to develop in line with the local features of periventricular leukomalacia prevention measures, attenuate the incidence of periventricular leukomalacia in preterm infants, reduce the periventricular leukomalacia in preterm infants with complications and improve the prognosis of periventricular leukomalacia.Methods: 60 cases periventricular leukomalacia as the observation group which are from 300 cases of preterm infants in our hospital in 2007 January to 2012 January, at the same time from the same period in selected 120 cases of non periventricular leukomalacia in children with children as a control group, physiological factors between the two groups(gestational age, body weight, gender, the mode of delivery), the pathological factors(pregnancy induced hypertension, anemia, placenta and umbilical cord abnormality, Miyamauchi Sako, neonatal circulatory disturbance, hypoxemia and difficult to correct hypoglycemia, maternal chorioamnionitis) and iatrogenic factors(Application of exogenous pulmonary surfactant, oxygen poisoning, ventilator) etc. high risk potential factors were analyzed by single factor analysis and multi factor. SPSS13.0 statistical software was used for statistical. Single factor analysis and application of x2 test, P<0.05 had statistical significance. Multi factor regression analysis using Logistic, calculating a 95% confidence interval of OR value and OR, so as to obtain the relationship between the size of the risk factors in the risk of the. At the same time, premature infants with periventricular leukomalacia in theearly clinical manifestations were summarized, in order to find early occurrence of periventricular leukomalacia in preterm infants. Comparing the different effect of periventricular leukomalacia in preterm infants were treated by different methods including control group: use warm, oxygen inhalation, infection control, acid-base imbalance and electrolyte disturbance, maintain normal blood glucose, blood pressure, comprehensive measures of blood gas, the treatment group based on the comprehensive treatment combined with ganglioside or brain protein hydrolysate injection. Compared with the rate of x2 test.Results: Single factor analysis showed that pregnant women with pregnancy induced hypertension disease, anemia, placenta and umbilical cord abnormality, Miyamauchi Sako, neonatal circulatory disturbance, hypoxemia and difficult to correct hypoglycemia, maternal chorioamnionitis have significant difference(P<0.05), gender history, mode of delivery, oxygen poisoning intravascular coagulation, exogenous surfactant has no significant difference(P>0.05). Multivariate Logistic regression analysis showed that pregnant women with hypertensive disorder complicating pregnancy, anemia, placenta and umbilical cord abnormality, fetal distress, neonatal circulatory disturbance, hypoxemia and difficult to correct hypoglycemia, maternal chorioamnionitis dangerous main factors of periventricular leukomalacia in preterm infants. The warm and combined with routine treatment, oxygen, to actively control the infection, acid-base imbalance and electrolyte disturbance, blood glucose, blood pressure, blood to maintain normal with gangliosides can reduce the occurrence of sequelae of periventricular leukomalacia in premature infants in the very great degree.Conclusion: Pregnant women with hypertensive disorder complicating pregnancy, anemia, placenta and umbilical cord abnormality, Miyamauchi Sako, neonatal circulatory disturbance, hypoxemia and difficult to correct hypoglycemia, maternal chorioamnionitis, unreasonable application of mechanical ventilation were independent risk factors of periventricular leukomalacia in preterm infants. Multivariate Logistic regression analysis showed that pregnant women with hypertensive disorder complicating pregnancy, anemia, placenta and umbilical cord abnormality, fetal distress, neonatal circulatory disturbance, hypoxemia and difficult to correct hypoglycemia, maternal chorioamnionitis, unreasonable application of mechanical ventilation were the main risk factors. Early discovery, early treatment ofrelated risk factors of periventricular leukomalacia, have important sense to prevent the occurrence of sequelae of periventricular leukomalacia in preterm infants. Early periventricular leukomalacia in preterm infants have no specific clinical manifestations, drug nutrition brain cells and active rehabilitation training to reduce the incidence of periventricular leukomalacia in preterm infants with complications can be achieved very good results, but should be reasonable, and should actively find risk factors, early prevention, reduce the occurrence of premature infants with periventricular leukomalacia, to improve the quality of life of the patients and reduce the incidence of complications.