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目的:了解早产儿颅内出血(ICH)的发病病因、CT表现、预后。方法:对200例早产儿(阴道自然分娩及剖宫产各100例)进行头颅CT检查,并定期复查CT。结果:200例早产儿中发现ICH53例,ICH检出率26%,有临产时缺氧史和有临床症状者42例,无明显临床症状者11例;ICH部位依次为蛛网膜下腔出血(SAH)37例,脑室周围-脑室出血(SEH/IVH)11例,脑实质出血(IPH)4例,小脑出血(ICEH)1例,53例中死亡11例。随访45例,其中正常30例,后遗症15例,其中SAH有3例预后较好;SEH/IVH7例及IPH2例的预后均差。结论:早产儿的ICH易漏诊,后遗症发生率高,头颅CT筛选是非常必要的,且预后与ICH部位及母体合并症及分娩关系密切,要重视孕期保健和分娩监护。
Objective: To understand the etiology, CT findings and prognosis of intracranial hemorrhage (ICH) in preterm infants. Methods: A total of 200 preterm infants (100 cases of spontaneous vaginal delivery and caesarean section) were examined by CT. Results: Among the 200 preterm infants, ICH were found in 53 cases, the ICH detection rate was 26%, there was a history of hypoxia during labor and 42 cases had clinical symptoms, while 11 cases showed no clinical symptoms. ICH sites were followed by subarachnoid hemorrhage There were 37 cases of SAH, 11 cases of periventricular - ventricular hemorrhage (SEH / IVH), 4 cases of intracerebral hemorrhage (IPH), 1 case of cerebellar hemorrhage (ICEH) and 11 cases of 53 cases. Follow-up 45 cases, including 30 cases of normal, 15 cases of sequelae, of which 3 cases of SAH good prognosis; SEH / IVH 7 cases and IPH2 cases were poor prognosis. Conclusion: ICH is easy to missed diagnosis, the incidence of sequelae is high, and cranial CT screening is very necessary. And the prognosis is closely related to ICH and maternal complications and childbirth. It is necessary to pay attention to the care during pregnancy and childbirth.