早产儿1122例脑室周围-脑室内出血发生率及其高危因素的分析(英文)  

Incidence rate and high-risk factors of peri-intraventricular hemorrhage in 1 122 preterm infants

作　　者：刘敬[1] 常立文[1] 高峰[2] 秦桂莲 王琪[2] 陈妍华 

机构地区：[1]华中科技大学同济医学院同济医院儿科,湖北省武汉市430030 [2]首都医科大学附属北京妇产医院,北京市100026 [3]秦皇岛市妇幼保健院,河北省秦皇岛市066000

出　　处：《中国组织工程研究与临床康复》2007年第4期788-790,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:脑室周围-脑室内出血是早产儿死亡和伤残的重要原因,大样本调查资料可为早产儿脑室周围-脑室内出血发生率及其高危因素的分析提供支持性数据。目的:认识早产儿脑室周围-脑室内出血的发生率及其高危因素。设计:调查分析。单位:华中科技大学同济医学院同济医院,首都医科大学附属北京妇产医院,河北省秦皇岛市妇幼保健院。对象:选择2002-01/2005-08在北京妇产医院和秦皇岛市妇幼保健院出生,并于生后1周内作头颅超声检查的早产儿1122例,男594例,女528例,胎龄26.3～36.8周,出生时体质量(850～4500)g。方法:1122例早产儿于生后1周内常规作头颅超声检查,并记录相关围产因素。使用仪器为NewPhilips5500型和GEHealthcareLogiq400型超声诊断仪(分别由荷兰Philip公司和美国GE公司生产)。主要观察指标:脑室周围-脑室内出血相关因素分析结果。结果:纳入早产儿1122例全部进入结果分析。其中619例发生了不同程度的脑室周围-脑室内出血(55.2%);重度出血占出血总数的17.8%。小胎龄、低体质量、机械通气、低血糖、高碳酸血症、高乳酸血症、酸中毒、缺氧、血液凝固机制异常等为早产儿颅内出血的主要高危因素,产前使用地塞米松可降低小胎龄早产儿颅内出血发生率。结论:早产儿出生后常规作头颅超声检查,早期发现并定期随访对减少神经系统后遗症有重要意义。BACKGROUND ： Peri-intraventricular hemorrhage （PIVH） in preterm infants is one of the most important reasons for mortality and disability. Moreover, investigative exponents may bring supported data for incidence rate of PIVH and high-risk factors of preterm infants with PIVH. OBJECTIVE ： To explore the incidence rate and analyze the high-risk factors of PIVH in preterm infants DESIGN ： Survey and analysis SETTING： Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology; Beijing Obstetrics ＆ Gynecology Hospital, Capital Medical Universit; Qinhuangdao Maternity and Infants＇ Hospital of Hebei Province. PARTICIPANTS ： A total of 1 122 preterm infants of 26.3-36.8 gestational age were selected from Beijing Obstetrics ＆ Gynecology Hospital, Qinhuangdao Maternity and Infants＇ Hospital from January 2002 to August 2005. All infants received ultrasonic examination on skull within 1 week. There were 594 boys and 528 girls, and the birth weight was 850-4 500 g. METHODS： All infants received ultrasonic examination on skull within 1 week. New Philips 5500 and GE Healthcare Logiq 400 ultrasonic diagnosis devices were provided by Philip Company, Dutch and GE Company, respectively. MAIN OUTCOME MEASURES ： The incidence rate and related high-risk factors of PIVH. RESULTS： All 1 122 preterm infants were involved in the final analysis. Among 1 122 preterm infants, 619 cases （55.2%） had PIVH; especially, 110 had severe PIVH with the degree more than Ⅲ, which was accounted for 17.8%. High-risk factors were mainly low gestational age, low birth weight, mechanical ventilation, hypoglycemia, hypercapnia, hyperlactic acidemia, acidosis, hypoxia, abnormal blood coagulation, and so on. Antenatal corticosteroid could reduce the incidence rate of PIVH. However, there was no obvious effect on preterm infants of old gestational age. CONCLUSION ： Routine intracranial ultrasonic examination is useful for the diagnosis of PIVH in preterm infants.

关 键 词：婴儿 早产 脑出血 超声检查 多普勒 经颅 危险因素 

分 类 号：R445.1[医药卫生—影像医学与核医学]