婴儿维生素K缺乏致颅内出血36例临床分析  

Intracranial hemorrhage in infants caused by vitamin K deficiency： a clinical analysis of 36 cases

作　　者：赵阳[1] 金惠明[1] 孙莲萍[1] 江峰[1] 马杰[1] 

机构地区：[1]上海交通大学医学院附属新华医院小儿神经外科,上海200092

出　　处：《中华神经医学杂志》2009年第11期1147-1151,共5页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（30770731）、上海市科委优秀学科带头人计划（09xD1403300）

摘　　要：目的探讨婴儿维生素K缺乏致颅内出血的临床特点、远期预后随访和预防。方法收集新华医院小儿神经外科白2000年11月至2007年9月收治的36例维生素K缺乏致颅内出血患儿的病史资料，对其病因、临床表现、影像学特点、诊断、治疗、预后及预防进行分析，其中13例患儿采用外科手术治疗，23例患儿采用内科药物治疗。结果住院治疗期间有1例患儿死亡，其余35例存在不同程度的改善。出院后经过半个月～7年的随访，手术治疗的患儿中1例死亡，1例留有后遗症：保守治疗的患儿中1例死亡，4例留有后遗症。结论及时诊断、尽早积极采取综合治疗措施可提高此病的抢救成功率，降低病死率及致残率。进行大规模科普宣传，提高人们对此病的重视程度，加强各种预防措施，对降低该病的发病率十分重要。Objective To appraise the clinical features, long-term prognosis and precaution of intracranial hemorrhage in infants caused by vitamin K deficiency. Methods Thirty-six patients with intracranial hemorrhage caused by vitamin K deficiency were admitted to our pediatric department from Nov. 2000 to Sep. 2007 and the etiology, clinical features, imaging characteristics, diagnosis, treatment, prognosis and precaution in these infants were retrospectively analyzed. Surgical treatments, including burr hole drainage, hematoma evacuation by craniotomy, hematoma evacuation and decompression by removing the bone plates and the ventricular drainage were performed on 13 patients. The other 23 patients accepted such medical conservative treatments as hemostasis, reducing of the intracranial pressure, sedation, spasmolysis, and supplement of vitamin K1. Results During hospitalization, 35 patients survived with varying degrees of improvement and 1 death. Successful follow-up from half a month to seven years after discharge from the hospital showed that 1 death and lwith neurological deficit appeared in the surgical patients, and 1 death and 4 with varying degrees of deficit in the patients with medical treatment. Conclusion Timely diagnosis and comprehensive treatments can increase the survival rate and reduce the mortality and morbidity of this disease. In addition, public awareness and preventive measures are important in reducing the incidence of this disease.

关 键 词：维生素K缺乏出血 颅内出血 婴儿 

分 类 号：R686[医药卫生—骨科学]