新生儿脑梗死1例  

A case of neonatal cerebral infarction

作　　者：吴璇[1] 刘克战[1] WU Xuan;LIU Kezhan(Department of Neonatal Internal Medicine,Children’s Hospital of Shanxi,Shanxi,Taiyuan 030000,China)

机构地区：[1]山西省儿童医院新生儿内科,山西太原030000

出　　处：《中国医药科学》2022年第8期197-200,共4页China Medicine And Pharmacy

摘　　要：新生儿脑梗死是指出生后28 d内新生儿的大脑动脉一个或多个分支因各种原因发生梗死,导致脑组织相应供血区域的缺血性损伤,患儿出生时多无特异临床表现,往往于生后数月才出现运动或认知功能障碍。因此,早期诊断比较困难,治疗往往滞后,对新生儿危害极大。本文报告1例新生儿脑梗死的诊治过程及体会,该例患儿日龄27 d,以惊厥起病,结合影像学检查提示为新生儿脑梗死急性期,在患儿凝血功能稳定、无出血倾向的前提下积极给予肝素钠抗凝治疗,患儿分别在治疗6 d及出院2个月后复查颅脑磁共振梗死灶明显缩小,无惊厥发作,无偏瘫表现,神经系统无异常体征,疾病恢复良好。故在凝血功能稳定、无活动性出血的情况下积极进行抗凝治疗,对于新生儿急性脑梗死的恢复有积极意义,为临床提供参考。Neonatal cerebral infarction refers to the infarction of one or more branches of neonatal cerebral artery for various reasons within 28 days after birth,which leads to the ischemic injury of the corresponding blood supply area of brain tissue.Children have no specific clinical manifestations at birth,and often have motor or cognitive dysfunction only a few months after birth.Therefore,early diagnosis is difficult and treatment often lags behind,which is extremely harmful to newborns.This paper reports the diagnosis and treatment of a newborn cerebral infarction.The child was 27 days old and started with convulsion.Combined with imaging examination,it was the acute stage of neonatal cerebral infarction.On the premise of stable coagulation function and no bleeding tendency,the child was actively given heparin sodium anticoagulation therapy.After 6 days of treatment and 2 months after discharge,the brain MRI infarct was significantly reduced,and there was no convulsion,no hemiplegia,no abnormal signs in nervous system,and the disease recovered well.Therefore,active anticoagulation treatment under the condition of stable coagulation function and no active bleeding is of positive significance for the recovery of neonatal acute cerebral infarction and provides reference for clinical practice.

关 键 词：新生儿 脑梗死 肝素钠 抗凝治疗 

分 类 号：R722.1[医药卫生—儿科]