中国实用儿科杂志

中国实用儿科杂志

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404例早产儿头颅B超检查结果及临床分析

王乐，李明霞，周英   

  1. 新疆医科大学第一临床医学院新生儿科,新疆乌鲁木齐，830054
  • 收稿日期:2006-03-10 修回日期:2006-06-15 出版日期:2006-09-06 发布日期:2006-09-06

Result of cranial Bultrasonography and clinical analysis of 404 cases of preterm infants.

Wang Le,Li Mingxia,Zhou Ying.   

  1. Department of Neonate,the First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China
  • Received:2006-03-10 Revised:2006-06-15 Online:2006-09-06 Published:2006-09-06

摘要： 目的调查新疆医科大学第一临床学院住院早产儿脑损伤发生率及影响因素。 方法对200308—200510新生儿科收治的404例早产儿应用ABR4000S/L B超诊断仪在生后3~7d内常规进行床边头颅B超检查。 结果150例早产儿存在脑损伤，平均胎龄为(33.27±1.99)周；平均出生体重(1992.9±505.2)g。总的脑室内出血(IVH)发生率为35.1%(142/404)，脑室周围白质软化(PVL)的发生率为3.5%(14/404)，轻度和重度脑损伤发生率分别为23.5%(95/404)、13.6%(55/404)。胎龄越小，体重越低，脑损伤发生率越高，但与颅内出血程度无关。窒息程度与脑损伤程度密切相关。并发症肺透明膜病、呼吸暂停、呼吸衰竭、肺出血、低血糖、多器官功能损害及贫血与脑损伤程度有关。母妊高征、胆汁淤积、胎膜早破、胎龄小、出生体重低及HFOV治疗可使早产儿脑损伤发生率增高。 结论早产儿脑损伤的发生及严重程度与多因素有关，头颅B超可对早产儿脑损伤作出早期诊断，为早期干预提供依据。

关键词: 早产儿, 脑损伤, 头颅B超

Abstract: AbstractObjectiveTo investigate the incidence of brain injury and risk factors. MethodsAll 404 cases hospitalized preterm infants were conventionally examined by the beside cranial ultrasound between 3 to 7 days after birth from Aug.2003 to Oct.2005. ResultsBrain injury was diagnosed in 150 cases.The mean gestational age of them was (33.27±1.99)weeks,and birthweight (1992.9±505.2)g.Total incidence of IVH and PVL was 35.2%(142/404) and 3.5%(14/404) respectively among all preterm infants,and the proportion of slight and severe brain injury was 23.5%(95/404) and 13.6%(55/404) respectively.The lower the gestational age and birthweight,the higher the incidence of brain injury,but it was not correlated with the level of IVH.The degree of asphyxia was closely related to the level of brain injury.The incidence of complications,such as RDS,apnea,respiratory failure,pulmonary hemorrhage,hypoglycemia,multiorgan function failure and anemia was related to the degree of brain injury.Pregnancyinduced hypertension syndrome,cholestasis,premature rupture of membranes,gestational age,birthweight and highfrequency oscillatory ventilation(HFOV) could make the incidence of brain injury higher. ConclusionThe incidence and level of preterm brain injury are related to many factors.We could diagnose early by cranial ultrasound and make it possible for us to intervene and treat these patients as early as possible in order to prevent the bad prognosis.

Key words: Brain injury, Cranial ultrasound