目的 探讨影响早产儿自发性肠穿孔（SIP）发生的危险因素。方法 采用回顾性病例对照研究设计，将2010 年1月至2020年6月收治的早产儿中符合SIP诊断的早产儿纳入SIP组，随机抽取同期、同胎龄、无肠穿孔早产儿为对照组， 分析比较两组间的临床特点，探讨SIP的危险因素。结果 研究期间共收治早产儿21 263例，其中SIP组28例，男14例、 女14例，穿孔日龄8.5（2 . 5 ~ 11 . 0）天，胎龄（32 . 9±2.5）周，出生体质量（1 831 .5±475. 2） g。同时纳入对照组61例，男 36例、女25例，胎龄（33 . 2±2.6）周，出生体质量（1 869.5±493.8） g。单因素分析结果显示，SIP组与对照组之间Ⅲ级 及以上的脑室周围-脑室内出血（PIVH）、早发性败血症、感染性休克、低蛋白血症、贫血、1周内使用多巴胺的比例差异 均有统计学意义(P<0.05)。结论 Ⅲ级及以上的PIVH、早发性败血症、感染性休克、低蛋白血症、贫血，以及1 周内使用多巴胺可能与SIP 发生有关。

Objective To explore the risk factors of spontaneous intestinal perforation (SIP) in premature infants. Methods A retrospective case-control study was designed. Preterm infants diagnosed of SIP and admitted from January 2010 to June 2020 were included in the SIP group. Preterm infants of the same gestational age and without intestinal perforation during the same period were randomly selected as the control group. The clinical characteristics between the two groups were analyzed and compared, and the risk factors of SIP were analyzed. Results A total of 21263 preterm infants were admitted during the study period, including 28 infants ( 14 boys and 14 girls) in the SIP group. The perforation age was 8 . 5 ( 2 . 5 - 11 . 0 ) days, gestational age was ( 32 . 9 ±2 . 5 ) weeks, and the birth weight was ( 1831 . 5 ±475 . 2 ) g. At the same time, 61 infants ( 36 boys and 25 girls) were included in the control group, with gestational age of ( 33 . 2 ±2 . 6 ) weeks and birth weight of ( 1869 . 5 ±493 . 8 ) g. Univariate analysis showed that there were statistically significant differences between the SIP group and the control group in the proportion of periventricular-intraventricular hemorrhage (PIVH) of grade Ⅲ and above, early-onset sepsis, septic shock, hypoproteinemia, anemia and dopamine exposure within one week (all P< 0 . 05 ). Conclusion PIVH grade Ⅲ and above, earlyonset sepsis, septic shock, hypoproteinemia, anemia, and dopamine exposure within one week may be related to SIP.