极低体重儿脑室内出血超声表现与临床因素关系探讨  

RELATIONSHIP BETWEEN VLBWI ULTRASONIC MANIFESTATION OF INTRAVENTRICULAR HEMORRHAGE AND CLINICAL CORRELATION FACTORS

作　　者：梁健 丁雪明[2] 李智贤[2] 马燕[2] 田桂湘[2] 庞彩霞[2] 周兴良 杜宇 

机构地区：[1]广西北流市人民医院超声科,北流537400 [2]广西医科大学第一附属医院超声科,南宁530021 [3]广西北流市人民医院儿科,北流537400

出　　处：《广西医科大学学报》2009年第3期359-362,共4页Journal of Guangxi Medical University

基　　金：国家"十一.五"科技支撑计划项目(No.2007BAI07A17-11);玉林市科学研究与技术开发项目(No.玉林科攻0866007)

摘　　要：目的：应用床边超声对极低体重儿（体重〈1500g）进行颅脑检查，判断有无脑室内出血（IVH），并探讨其严重程度与临床相关危险因素的关系。方法：对73例极低体重儿出生后3～7d内常规行床边颅脑超声检查，记录分娩前后的临床因素，且于一周后行颅脑超声复查。结果：73例极低体重儿中IVH发生率76．71％（56／73），轻度IVH占39．73％（29／73）；重度IVH占36．99％（27／73），一周后复查，其中重度IVH中15例程度加重，占55．56％（15／27）；IVH患儿中有19例在一周治疗后复查时出现侧脑室中度扩张，占26．03％（19／73）。极低体重早产儿胎龄越小，出生体重越低，IVH发生率越高，出生窒息、呼吸暂停可以引起或加重IVH（P〈0．05）。结论：极低体重儿IVH发生率较高，床边颅脑超声检查可早期诊断及观察其病程演变，是临床诊断极低体重儿IVH首选的影像学技术，适宜在基层医疗卫生机构推广。Objective：To investigate the value of ultrasonography in estimating the degree of intraventricular hemorrhage（IVH） in very low birth weight infants（VLBWI） and to analyze the risk factors associated with the clinical relationship. Methods：Seventy-three VLBWIs were examined by bedside ultrasound 3 to 7 days after birth, and were re-examined by ultrasound a week after treatment. Results： The incidence rates of IVH,mild IVH and severe IVH were 76.71%（56/73）,39.73%（29/73）,and 36.99%（27/73）,respectively. Fifteen patients of IVH got aggravated after one week 55.56% （15/27）. Nineteen patients（26.03%） with severe IVH developed lateral cerebral ventricle dilatated when they were re-examined one week after treatment. Small-for-gestational age and low birth-weight were associated with a significant risk of IVH. Premature infant with asphyxia history, respiratory functional lability could cause or make IVH aggravated （ P〈0.05）. Conclusion： There is high incidence of IVH in VLBWlS,cerebral ultrasound can early diagnose and observe the course of disease. So it is the best choice for imaging technology in clinical diagnosis of IVH, in particular it is an appropriate choice for rural medical institutions.

关 键 词：极低体重儿 脑室内出血 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]